OrganizationActive
1019 Wicker Street Operating Company, LLC
NPI 1871035485 · Skilled Nursing Facility · Ticonderoga, NY
Provider details
- NPI number
- 1871035485
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Authorized official
- Jeffrey Rubin, Co-Chief Executive Officer
Mailing address
500 Seneca St Ste 100
Buffalo, NY 14204-1963
Registry dates
- Enumerated
- 2016-11-14
- Last updated
- 2023-01-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.