Healthcare Provider Details

I. General information

NPI: 1245729847
Provider Name (Legal Business Name): NASSAU HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 JERUSALEM AVE
UNIONDALE NY
11553
US

IV. Provider business mailing address

2201 HEMPSTEAD TURNPIKE
EAST MEADOW NY
11554
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-1400
  • Fax: 516-296-7376
Mailing address:
  • Phone: 516-296-7450
  • Fax: 516-296-7376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2950303N
License Number StateNY

VIII. Authorized Official

Name: BELINDA KAVANAGH-LANTIMO
Title or Position: CREDENTIALING ENROLLMENT MANAGER
Credential:
Phone: 516-572-5135