KDG Operating Company, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

15C000 Issued in NJ

Legal business name

KDG OPERATING COMPANY, LLC

Doing business as

Ivystone Senior Living

Practice address

7999 N Crescent Blvd
Pennsauken, NJ 08110-1402

Phone

(856) 488-5557

Fax

(856) 488-9523

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Raymond T. Dioguardi

Title

Coo/Cfo

Phone

(516) 496-1505

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ivystone Senior Living Doing business as

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1306969829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KAPLAN DEVELOPMENT GROUP",
            "address_2": "100 JERICHO QUADRANGLE SUITE 142",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532408",
            "telephone_number": "516-496-1505",
            "fax_number": "516-496-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7999 N CRESCENT BLVD",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081101402",
            "telephone_number": "856-488-5557",
            "fax_number": "856-488-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KDG OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "DIOGUARDI",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "COO/CFO",
        "authorized_official_telephone_number": "516-496-1505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "15C000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104124",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivystone Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aliyah Jones-Griffith
• Marquia S Jones, LAC
• Michael Jones
• Tatyana Kaganova, D.M.D., M.S.
• Ashlyn Kang, PHARMD
• Christine Kelly, APN-C
• Dara Kelly
• Aurangzaib Khan, DDS
• Marlon Ingaywa Kidiiga, PHARM.D.
• King of Rock Drywall and Finishing LLC

• Assisted Living Facility in Pennsauken, NJ
• Providers in Pennsauken, NJ by specialty
• Assisted Living Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.