Palisade Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

060904 Issued in NJ

Legal business name

PALISADE OPERATIONS, LLC

Doing business as

PALISADE HEALTHCARE

Practice address

6819 Boulevard East
Guttenberg, NJ 07093-4501

Phone

(201) 868-3600

Fax

(201) 868-3013

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Sam Stern

Title

Comptroller

Phone

(718) 567-0400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PALISADE HEALTHCARE Doing business as

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435190400000",
    "number": "1831131242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST",
            "address_2": "SUITE 220",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "718-567-0400",
            "fax_number": "718-567-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6819 BOULEVARD EAST",
            "city": "GUTTENBERG",
            "state": "NJ",
            "postal_code": "070934501",
            "telephone_number": "201-868-3600",
            "fax_number": "201-868-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALISADE OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2015-06-25",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "718-567-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4479106",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALISADE HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Komal R Patel-Dilwali, CNM, WHNP-BC
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• Skilled Nursing Facility in Guttenberg, NJ
• Providers in Guttenberg, 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 Jun 25, 2015; 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.