Organization
KOMANOFF CENTER FOR GERIATRIC & REHAB MEDICINE
Active
Other names
The Komanoff Center for Geriatric & Rehabilitative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX SKUTZKA (ADMINISTRATOR)
(516) 897-1212
Entity
Organization
Contact information
Practice address
375 EAST BAY DRIVE, LONG BEACH, NY 11561
(516) 897-1065
(516) 897-1064
Mailing address
375 EAST BAY DRIVE, LONG BEACH, NY 11561
(516) 897-1065
(516) 897-1064
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2902302N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00313988
—
NY
01
—
009461
BLUE CROSS
—
Enumeration date
07/25/2006
Last updated
12/16/2014
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