Provider Demographics
NPI:1366424350
Name:UNION PLAZA NURSING HOME INC
Entity type:Organization
Organization Name:UNION PLAZA NURSING HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADINAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-670-0700
Mailing Address - Street 1:3323 UNION ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3323 UNION ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3050
Practice Address - Country:US
Practice Address - Phone:718-670-0700
Practice Address - Fax:718-670-0742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY700339N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01707102Medicaid
NY335799Medicare Oscar/Certification
NY1190410001Medicare NSC