Provider Demographics
NPI:1174520704
Name:GLENGARIFF CORPORATION
Entity type:Organization
Organization Name:GLENGARIFF CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:AHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-676-1100
Mailing Address - Street 1:141 DOSORIS LN
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1225
Mailing Address - Country:US
Mailing Address - Phone:516-676-1100
Mailing Address - Fax:516-759-0267
Practice Address - Street 1:141 DOSORIS LN
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-1225
Practice Address - Country:US
Practice Address - Phone:516-676-1100
Practice Address - Fax:516-759-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2901300N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00313039Medicaid
NY335211Medicare Oscar/Certification