Eden Park Health Services, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5601305N Issued in NY

Legal business name

EDEN PARK HEALTH SERVICES, INC.

Practice address

170 Warren St
Glens Falls, NY 12801-4525

Phone

(518) 793-5163

NPI assigned

Nov 8, 2006

Organization subpart

No

Name

Robert Glock

Title

President

Phone

(518) 436-4731

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

• Eden Park Health Services, Inc

  • Assisted Living Facility
  • Troy, NY
  • NPI 1891865432
  NPD tax ID
• Eden Park Health Services, Inc.

  • Skilled Nursing Facility
  • Poughkeepsie, NY
  • NPI 1548330624
  NPD tax ID
• Eden Park Health Services, Inc.

  • Skilled Nursing Facility
  • Utica, NY
  • NPI 1619047750
  NPD tax ID
• Eden Park Health Services, Inc.

  • Skilled Nursing Facility
  • Catskill, NY
  • NPI 1790855864
  NPD tax ID

Tax ID family

Eden Park Health Care Center (5 organizations share this tax ID)

• Eden Park Health Care Center Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093885147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122091713",
            "telephone_number": "518-436-4731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 WARREN ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014525",
            "telephone_number": "518-793-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN PARK HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLOCK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-436-4731"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5601305N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312221",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eden Park Health Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ann Dys, FNP
• Michelle L Eastman, NNP
• Michaela Jean Ebert, MS, OTR/L
• Behrooz Ebrahimi-Fard, MD
• Eckerd Corporation
• Jocelyn Paige Edens, CNM
• Lynn Edgerly, LCSW R
• Joanne Egnaczyk, LPN
• Andrea Eichler, RNFA
• Thomas Eigo, D.D.S.

• All providers in Glens Falls, NY
• Skilled Nursing Facility in New York

• 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.