1W
1019 WICKER STREET OPERATING COMPANY, LLC
Skilled Nursing Facility
OIG CLEARNPI VERIFIED
Location
TICONDEROGA, NY
Licensed since
2016
Rate
—
Federal identifiers
NPI registry number1871035485
Agency details
Medicare activity
StatusNo Medicare utilization on file — neutral.
Authorized official
NameJEFFREY RUBIN
TitleCO-CHIEF EXECUTIVE OFFICER
Phone5185852831
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Source: NPI Registry · Last refreshed June 24, 2026