Organization
ST JOHNLAND NURSING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JEAN WEBER (CEO ADMIN)
(631) 269-5800
Entity
Organization
Contact information
Practice address
395 SUNKEN MEADOW RD, KINGS PARK, NY 11754-1000
(631) 269-5800
(631) 269-5876
Mailing address
395 SUNKEN MEADOW RD, KINGS PARK, NY 11754-1000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5157311N
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00309393
—
NY
01
—
3349328
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/24/2006
Last updated
09/11/2025
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