Healthcare Provider Details

I. General information

NPI: 1336553080
Provider Name (Legal Business Name): SHORE VIEW ACQUISITION I, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 BRIGHTON 3RD ST
BROOKLYN NY
11235-6762
US

IV. Provider business mailing address

2865 BRIGHTON 3RD ST
BROOKLYN NY
11235-6762
US

V. Phone/Fax

Practice location:
  • Phone: 718-891-4400
  • Fax:
Mailing address:
  • Phone: 718-891-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7001399N
License Number StateNY

VIII. Authorized Official

Name: PASQUALE DEBENEDICTIS
Title or Position: MANAGER / MEMBER
Credential:
Phone: 516-422-7818