Healthcare Provider Details

I. General information

NPI: 1336662840
Provider Name (Legal Business Name): THE ROSALIND AND JOSEPH GURWIN JEWISH GERIATRIC CENTER OF LONG ISLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 07/21/2022
Certification Date: 01/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 HAUPPAUGE RD
COMMACK NY
11725-4403
US

IV. Provider business mailing address

68 HAUPPAUGE RD
COMMACK NY
11725-4403
US

V. Phone/Fax

Practice location:
  • Phone: 631-715-2518
  • Fax: 631-715-2723
Mailing address:
  • Phone: 631-715-2518
  • Fax: 631-715-2723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK FRANCIS DONNELLAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 631-715-2518