Organization
ST. JAMES PLAZA NURSING FACILITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT A. BAFFA MA, NHA (ADMINISTRATOR)
(631) 862-8990
Entity
Organization
Contact information
Practice address
273 MORICHES RD, SAINT JAMES, NY 11780-2117
(631) 862-8990
(631) 862-6792
Mailing address
273 MORICHES RD, SAINT JAMES, NY 11780-2117
(631) 862-8990
(631) 862-6792
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5157308N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00312029
—
NY
01
—
009536
EMPIRE BLUE CROSS
NY
01
—
522087699
COMMONWEALTH INDEMNITY
NY
Enumeration date
11/28/2006
Last updated
12/09/2009
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