Organization · Type 2 NPI

170 West Avenue Operating Company, LLC

Skilled Nursing Facility · Brockport, NY

NPI number 1245784271 Active

Practice location

170 West Ave
Brockport, NY 14420-1227

Call (585) 395-6052 Map

Mailing address

500 Seneca St Ste 100
Buffalo, NY 14204-1963

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

5 other providers at this address

Other skilled nursing facility providers in Brockport

Lakeside Beikirch Care Center, Inc.Skilled Nursing Facility Brockport, NY NPI 1891791927

See all in Brockport →

NPI record

NPI: 1245784271
Entity type: Organization (Type 2)
Issued: Aug 8, 2016
Last updated: Jan 19, 2023
Status: Active

Other names

<unavail>
Elderwood of Lakeside at Brockport · doing business as
Elderwood of Lakeside at Brockport · doing business as

Authorized official

Dr. Jeffrey Rubin
Co- Chief Executive Officer
(716) 817-5075

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1245784271

170 West Avenue Operating Company, LLC's National Provider Identifier is 1245784271, issued on Aug 8, 2016. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Brockport, NY. The record was last updated on Jan 19, 2023.