Healthcare Provider Details

I. General information

NPI: 1093708646
Provider Name (Legal Business Name): ROCKVILLE SKILLED NURSING & REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MAINE AVE
ROCKVILLE CENTRE NY
11570-3608
US

IV. Provider business mailing address

50 MAINE AVE
ROCKVILLE CENTRE NY
11570-3608
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-8000
  • Fax:
Mailing address:
  • Phone: 516-536-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ARI GLUCK
Title or Position: ASST. ADMINISTRATOR
Credential:
Phone: 516-536-8000