Sprain Brook Manor Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5910300N Issued in NY

Legal business name

SPRAIN BROOK MANOR NURSING HOME

Practice address

77 Jackson Ave
Scarsdale, NY 10583-3140

Phone

(914) 472-3200

Fax

(914) 472-5443

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Joanne Wallak

Title

Administrator

Phone

(914) 472-3200

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649285479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 JACKSON AVE",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105833140",
            "telephone_number": "914-472-3200",
            "fax_number": "914-472-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 JACKSON AVE",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105833140",
            "telephone_number": "914-472-3200",
            "fax_number": "914-472-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRAIN BROOK MANOR NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLAK",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "914-472-3200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5910300N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING CERTIFICATE NO.",
            "identifier": "5910300N",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PFI",
            "identifier": "1114",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00308338",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spine and Pain Medical PLLC
• Nina N Spooner, M.D.
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic
• Sportsmedicine Rehabilitation
• Sprain Brook Hearing Aid Center Inc
• Sprain Brook Manor Rehab LLC
• Tara Sreedharan
• Eleonore Srinivasan, L. AC.
• Kate Evelyn St Phillip
• Madison Stangel, OTR/L

• Skilled Nursing Facility in Scarsdale, NY
• Providers in Scarsdale, 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 22, 2020; 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.