Healthcare Provider Details

I. General information

NPI: 1538119011
Provider Name (Legal Business Name): NORTH SEA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 COUNTY ROAD 39
SOUTHAMPTON NY
11968-5215
US

IV. Provider business mailing address

64 COUNTY ROAD 39
SOUTHAMPTON NY
11968-5215
US

V. Phone/Fax

Practice location:
  • Phone: 718-986-7317
  • Fax:
Mailing address:
  • Phone: 718-986-7317
  • 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: MR. ROBERT T. KOLMAN
Title or Position: MEMBER
Credential:
Phone: 516-869-3700