Organization
CENTRAL SUFFOLK HOSPITAL
Active
Other names
Peconic Bay Skilled Nursing Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD MCMANUS (VP OF OPERATIONS)
(631) 548-6071
Entity
Organization
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6000
(631) 548-6007
Mailing address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6000
(631) 548-6007
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5155000N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009459
BLUE CROSS
NY
05
—
01040922
—
NY
Enumeration date
05/25/2006
Last updated
01/20/2015
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