Provider Demographics
NPI:1386899771
Name:CPRNC, LLC
Entity type:Organization
Organization Name:CPRNC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EFRAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-371-8100
Mailing Address - Street 1:1 HILLCREST CENTER DRIVE
Mailing Address - Street 2:SUITE 325
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977
Mailing Address - Country:US
Mailing Address - Phone:845-371-8100
Mailing Address - Fax:315-478-0688
Practice Address - Street 1:116 MARTIN LUTHER KING E
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205-1110
Practice Address - Country:US
Practice Address - Phone:315-475-1641
Practice Address - Fax:315-478-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3301326N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00474415Medicaid
NY335253001Medicare PIN