Organization
PORT JEFFERSON OPERATING LLC
Active
Other names
Waters Edge Rehab & Nursing Center at Port Jefferson
Organization subpart
No
Provider details
NPI number
Authorized official
MARK FRIEDMAN (MANAGER / MEMBER)
(917) 596-1800
Entity
Organization
Contact information
Practice address
150 DARK HOLLOW RD, PORT JEFFERSON, NY 11777-2048
(631) 473-5400
Mailing address
150 DARK HOLLOW RD, PORT JEFFERSON, NY 11777-2048
(631) 473-5400
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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