Healthcare Provider Details

I. General information

NPI: 1528052180
Provider Name (Legal Business Name): OCEAN GARDENS NURSING FACILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64-11 BEACH CHANNEL DR
ARVERNE NY
11692-1412
US

IV. Provider business mailing address

64-11 BEACH CHANNEL DR
ARVERNE NY
11692-1412
US

V. Phone/Fax

Practice location:
  • Phone: 718-345-0700
  • Fax:
Mailing address:
  • Phone: 718-345-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7003389N
License Number StateNY

VIII. Authorized Official

Name: MR. BARRY DUKES
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-945-0700