Organization
AVALON GARDENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AKIVA FOGEL FOGEL (ADMINISTRATOR)
(631) 724-2200
Entity
Organization
Contact information
Practice address
7 ROUTE 25A, SMITHTOWN, NY 11787-1626
(631) 724-2200
Mailing address
211 SYMPHONY DR, LAKE GROVE, NY 11755-1318
(631) 642-7006
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
195281
NY
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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