Provider Demographics
NPI:1154973063
Name:PINNACLE GROUP OF HUDSON VALLEY IV LLC
Entity type:Organization
Organization Name:PINNACLE GROUP OF HUDSON VALLEY IV LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NACHFOLGER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NREMTP
Authorized Official - Phone:845-596-6633
Mailing Address - Street 1:3 VILLA LN
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1021
Mailing Address - Country:US
Mailing Address - Phone:845-596-6633
Mailing Address - Fax:
Practice Address - Street 1:42 ANTHOINE ST
Practice Address - Street 2:
Practice Address - City:S PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-4403
Practice Address - Country:US
Practice Address - Phone:207-799-8561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No291U00000XLaboratoriesClinical Medical Laboratory