Woodland Village LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

600-F-248 Issued in NY

Legal business name

WOODLAND VILLAGE LLC

Doing business as

Fawn Ridge Senior Living

Practice address

2902 Tibbits Ave
Troy, NY 12180-7077

Phone

(518) 273-2040

NPI assigned

Mar 23, 2016

Last updated

Mar 23, 2016By 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

Mr. Neil Zelman

Title

Coo

Phone

(845) 357-7387

Specialties & licenses 1

Addresses

Other names 1

• Fawn Ridge Senior Living Doing business as

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1417319021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 TIBBITS AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121807077",
            "telephone_number": "518-273-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 TIBBITS AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121807077",
            "telephone_number": "518-273-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND VILLAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "ZELMAN",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "845-357-7387",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NY",
            "license": "600-F-248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fawn Ridge Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha Woitkoski, DPT
• Michael Wolff
• Russell Wolff, PH.D.
• Barbara W Wolner, M.D.
• Jill Wolski, LCSW
• Morgan M Woodlief
• Kelsey Elizabeth Woods
• Vidia Wray, MS/CAS
• Kathleen Cannon Wright, PT
• Wynantskill Chiropractic PC

• Assisted Living Facility in Troy, NY
• Providers in Troy, NY by specialty
• Assisted Living Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.