Sr-73 and Lakeside Avenue Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SR-73 AND LAKESIDE AVENUE OPERATIONS LLC

Practice address

113 Route 73
Voorhees, NJ 08043-9573

Phone

(610) 925-2009

Fax

(610) 347-4098

NPI assigned

Sep 25, 2012

Organization subpart

No

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

Authorized official

Name

Jane Dropeskey

Title

Corporate Manager

Phone

(610) 925-4231

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PowerBack Rehabilitation, 113 South Route 73 Doing business as

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1063763464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-2009",
            "fax_number": "610-347-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 ROUTE 73",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439573",
            "telephone_number": "610-925-2009",
            "fax_number": "610-347-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SR-73 AND LAKESIDE AVENUE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "DROPESKEY",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "610-925-4231"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "31-5513",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PowerBack Rehabilitation, 113 South Route 73",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christa Spence, OTR/L
• Shae Caroline Spicer, MSN, APN, FNP-BC
• Spine Pain Rehab, LLC
• Talya R Spivack, MD
• Christian Michael Squillante, MD
• Rebecca Sragow, BCBA
• Prathiba Srinidhi, DMD
• Aarthi Srinivasan, MD
• St Chris Onsite Pediatric Partners LLC
• Linda Barney St. Martin, DPM

• Skilled Nursing Facility in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.