Organization
CREST HALL CORP.
Active
Other names
Creat Hall Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB DIMANT M.D. (PRESIDENT)
(631) 924-8830
Entity
Organization
Contact information
Practice address
63 OAKCREST AVE, MIDDLE ISLAND, NY 11953-1415
(631) 924-8830
Mailing address
63 OAKCREST AVE, MIDDLE ISLAND, NY 11953-1415
(631) 924-8830
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5151314N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01995922
—
NY
Enumeration date
08/24/2005
Last updated
02/06/2008
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