Organization
PENINSULA GENERAL NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER SKUTZKA (ADMINISTRATOR)
(718) 734-2000
Entity
Organization
Contact information
Practice address
50-15 BEACH CHANNEL DRIVE, FAR ROCKAWAY, NY 11691
(718) 734-2000
Mailing address
50-15 BEACH CHANNEL DRIVE, FAR ROCKAWAY, NY 11691
(718) 734-2000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
7003308N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00332834
—
NY
01
—
00796
EMPIRE BLUECROSS
NY
Enumeration date
06/20/2005
Last updated
09/05/2014
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