St Teresas Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3501302N Issued in NY

Legal business name

ST TERESAS NURSING HOME INC

Doing business as

St Teresas Nursing & Rehabilitation Center

Practice address

120 Highland Avenue
Middletown, NY 10940

Phone

(845) 342-1033

Fax

(845) 344-5631

NPI assigned

Jun 8, 2005

Organization subpart

No

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

Authorized official

Name

Annmarie Covone

Title

SRVP Cfo

Phone

(646) 633-4702

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• St Teresas Nursing & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1114921004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HIGHLAND AVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109404713",
            "telephone_number": "845-342-1033",
            "fax_number": "845-344-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HIGHLAND AVENUE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10940",
            "telephone_number": "845-342-1033",
            "fax_number": "845-344-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST TERESAS NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "COVONE",
        "authorized_official_first_name": "ANNMARIE",
        "authorized_official_title_or_position": "SRVP CFO",
        "authorized_official_telephone_number": "646-633-4702"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "3501302N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310738",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING CERTIFICATE",
            "identifier": "3501302N",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Teresas Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Sposito, MD
• Amy E. Spoto, MD
• Tara Spruill, FNP
• Saidapet Sridhar, D.D.S
• Carrie Ann St Amand, RPA-C
• Matthew Staback, DPT
• Melissa Ann Stack, PSYD
• Stafford Labs Orthotics and Prosthetics, Inc.
• Kweon Stambaugh, M.D.
• Elisabeth Stampfel

• Skilled Nursing Facility in Middletown, NY
• Providers in Middletown, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.