Healthcare Provider Details

I. General information

NPI: 1275521064
Provider Name (Legal Business Name): OCEANSIDE CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2914 LINCOLN AVE
OCEANSIDE NY
11572-2141
US

IV. Provider business mailing address

2914 LINCOLN AVE
OCEANSIDE NY
11572-2141
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-2300
  • Fax: 516-536-2320
Mailing address:
  • Phone: 516-536-2300
  • Fax: 516-536-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2950314N
License Number StateNY

VIII. Authorized Official

Name: MR. ELI SHALEV
Title or Position: CONTROLLER
Credential:
Phone: 718-592-9200