NPIMap

Organization Active NPI

Irvington Healthcare Providers LLC

Doing business as Chancellor Specialty Care Center

  • Skilled Nursing Facility
  • Irvington, NJ
National Provider Identifier
1063454494
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
060736 Issued in NJ
Legal business name
IRVINGTON HEALTHCARE PROVIDERS LLC
Doing business as
Chancellor Specialty Care Center
Practice address
155 40TH St
Irvington, NJ 07111-1184
Phone
(973) 371-7878
Fax
(973) 371-4081
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Sam Stern
Title
Comptroller
Phone
(718) 576-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 060736 NJ Primary

Addresses

Primary practice location

155 40TH St
Irvington, NJ 07111-1184

Mailing address

170 53Rd St
3Rd Floor
Brooklyn, NY 11232-4319
Phone (718) 567-0400

Other identifiers 1

IdentifierTypeStateIssuer
5057906MedicaidNJ

Other names 1

  • CHANCELLOR SPECIALTY CARE CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alaris Health at Essex - Vent3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063454494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 53RD ST",
            "address_2": "3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112324319",
            "telephone_number": "718-567-0400",
            "fax_number": "718-567-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 40TH ST",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111184",
            "telephone_number": "973-371-7878",
            "fax_number": "973-371-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVINGTON HEALTHCARE PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "718-576-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5057906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHANCELLOR SPECIALTY CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.