104 Old Niagara Road Operating Company, LLC
NPI #1902339054 in Lockport, New York
Provider Information
- NPI Number
- 1902339054
- Entity Type
- Organization
- Organization Name
- 104 Old Niagara Road Operating Company, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Apr 5, 2017
- Last Updated
- Jan 19, 2023
Practice Location
Authorized Official
- Name
- DR. JEFFREY RUBIN
- Title
- CO-CHIEF EXECUTIVE OFFICER
- Phone
- (716) 817-5075
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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