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Contact Information

PENINSULA GENERAL NURSING HOME
50-15 BEACH CHANNEL DRIVE
FAR ROCKAWAY, NY11691
 Phone: 718-734-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for PENINSULA GENERAL NURSING HOME

NPI Number 1114922689
LBN Legal business name PENINSULA GENERAL NURSING HOME
Authorized official ALEXANDER SKUTZKA - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/20/2005
Last updated 09/05/2014 - About 12 years ago
Identifiers
NY License # 7003308N
NY Medicaid 00332834
NY Other 00796 EMPIRE BLUECROSS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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