Organization
OZANAM HALL OF QUEENS NURSING HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP ANN BOWDEN LNHA (ADMINISTRATOR)
(718) 423-2000
Entity
Organization
Contact information
Practice address
4241 201ST ST, BAYSIDE, NY 11361-2550
(718) 423-2000
(718) 971-2071
Mailing address
4241 201ST ST, BAYSIDE, NY 11361-2550
(718) 423-2000
(718) 971-2071
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00309691
MEDICAID PROVIDER NUMBER
NY
01
—
1396825543
NPI
NY
01
—
1670
PFI NUMBER
NY
05
—
7003306N
—
NY
Enumeration date
10/16/2006
Last updated
11/10/2009
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