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Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL ZEIDMAN (CFO)
(718) 471-1311
Entity
Organization

Contact information

Practice address
210 BEACH 47TH ST, FAR ROCKAWAY, NY 11691-1100
(718) 471-1311
Mailing address
210 BEACH 47TH ST, FAR ROCKAWAY, NY 11691-1100

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04480686
NY
Enumeration date
10/30/2020
Last updated
10/30/2020
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