Healthcare Provider Details

I. General information

NPI: 1831023613
Provider Name (Legal Business Name): MAGENTA BP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 S SEGRAVE ST
DAYTONA BEACH FL
32114-4815
US

IV. Provider business mailing address

554 GOLF DR
VALLEY STREAM NY
11581-3546
US

V. Phone/Fax

Practice location:
  • Phone: 845-521-4935
  • Fax:
Mailing address:
  • Phone: 845-521-4935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SHMUEL SALOMON
Title or Position: PRESIDENT
Credential:
Phone: 845-521-4935