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Organization
QUEENS BOULEVARD EXTENDED CARE FACILITY CORP
Active
Organization
QUEENS BOULEVARD EXTENDED CARE FACILITY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH R MALONE CPA (CFO)
(718) 205-0298
Entity
Organization
Contact information
Practice address
6111 QUEENS BLVD, WOODSIDE, NY 11377-4965
(718) 205-0298
Mailing address
6111 QUEENS BLVD, WOODSIDE, NY 11377-4965
(718) 205-0298
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
2278P1005X
Pulmonary Rehabilitation Certified Respiratory Therapist
—
—
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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