| Organization Name: | NISKAYUNA OPERATING COMPANY, LLD |
| NPI Number: | 1326457714 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TANA DAWN GAYLORD (EXECUTIVE ASSISTANT) |
| Mailing Address: | 1805 Providence Ave Niskayuna |
| State: | NY US |
| Postal Code: | 123093923 |
| Phone Number: | 5183742212 |
| Fax Number: | 5183744330 |
| NPI Enumeration Date: | 08/11/2014 |
| NPI Last Update Date: | 08/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3140N1450X |
| License Number: | 4662302N |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Skilled Nursing Facility |
| Taxonomy Specialization: | Nursing Care, Pediatric |
| Taxonomy Definition: | A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |