Stratford Manor Care & Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

060714 Issued in NJ

Legal business name

STRATFORD MANOR CARE & REHABILITATION CENTER LLC

Practice address

787 Northfield Ave
West Orange, NJ 07052-1131

Phone

(973) 731-4500

Fax

(973) 592-0226

NPI assigned

Jun 21, 2005

Last updated

Mar 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah Condorelli

Title

Vice President Finance and

Phone

(200) 767-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northfield Manor Former legal business name

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1306842745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MCCLELLEN ST",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076481555",
            "telephone_number": "201-767-0100",
            "fax_number": "201-881-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521131",
            "telephone_number": "973-731-4500",
            "fax_number": "973-592-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRATFORD MANOR CARE & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "CONDORELLI",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE AND",
        "authorized_official_telephone_number": "200-767-0100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8876801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northfield Manor",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Skilled Nursing Facility in West Orange, NJ
• Providers in West Orange, 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 17, 2009; 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.