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104 Old Niagara Road Operating Company, LLC

Skilled Nursing Facility in Lockport, NY · enumerated 2017 · authorized official Jeffrey Rubin, Co-Chief Executive Officer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1902339054

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Registry record

Entity type Organization (Type 2)
Legal business name 104 Old Niagara Road Operating Company, LLC
Other name <Unavail>
Practice address 104 Old Niagara Rd, Lockport, NY, 14094
Phone (716) 434-8039
Enumeration date Apr 5, 2017
Last updated in NPPES Jan 19, 2023

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities Primary

Authorized official

Name Jeffrey Rubin
Title Co-Chief Executive Officer
Phone (716) 817-5075

Other identifiers

Identifier Type State Issuer
00356372 Medicaid NY -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for 104 Old Niagara Road Operating Company, LLC?
The NPI for 104 Old Niagara Road Operating Company, LLC is 1902339054, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for 104 Old Niagara Road Operating Company, LLC?
NPPES lists Jeffrey Rubin (Co-Chief Executive Officer) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-01-19.