Healthcare Provider Details

I. General information

NPI: 1669875183
Provider Name (Legal Business Name): OPTIMAL CARE OF ROCKLAND VENTURES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 N MIDDLETOWN RD
PEARL RIVER NY
10965-1216
US

IV. Provider business mailing address

282 N MIDDLETOWN RD
PEARL RIVER NY
10965-1216
US

V. Phone/Fax

Practice location:
  • Phone: 201-838-0239
  • Fax:
Mailing address:
  • Phone: 201-838-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number334880
License Number StateNY

VIII. Authorized Official

Name: YVES E CASIMIR
Title or Position: NURSE PRACTITIONER
Credential: FNP
Phone: 201-838-0239