Hyde Park Nursing Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1356302N Issued in NY

Legal business name

HYDE PARK NURSING HOME, INC.

Practice address

4975 Albany Post Road
Staatsburg, NY 12580

Phone

(845) 889-4500

Fax

(845) 889-4309

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Raphael Yenowitz

Title

Administrator

Phone

(845) 889-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1467471375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4975 ALBANY POST ROAD",
            "city": "STAATSBURG",
            "state": "NY",
            "postal_code": "12580",
            "telephone_number": "845-889-4500",
            "fax_number": "845-889-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4975 ALBANY POST ROAD",
            "city": "STAATSBURG",
            "state": "NY",
            "postal_code": "12580",
            "telephone_number": "845-889-4500",
            "fax_number": "845-889-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "YENOWITZ",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "845-889-4500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "1356302N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310283",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eileen Lorraine Goepfert
• Brandy Haight
• Joanna Hamilton, O.T.
• Loretta Merz Hill, L.P.N.
• Alexandra Marlene Hopkins, M.S., CCC-SLP
• Tara Rosemarie James-Lamonica
• Brianna Jimenez, LPN
• Abbey Kennedy, M.S., OTR/L
• Heather Sarah Kennedy, COTA
• Casey I Kirkpatrick, MS CCC-SLP

• Skilled Nursing Facility in Staatsburg, NY
• Providers in Staatsburg, 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 Aug 17, 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.