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General NPI Number Information
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NPI Number | 1932416765
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Entity Type | Organization
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Legal Business Name | JAY Z NURSING CARE
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 60 CHAMPLAIN AVENUE
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City | BELLPORT
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State | NY
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Zip | 11713-2004
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Country | US
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Telephone | 631-445-8217
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Fax |
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Provider Business Mailing Address
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Address Line | 60 CHAMPLIN AVE
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City | BELLPORT
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State | NY
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Zip | 11713-2004
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Country | US
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Telephone | 631-445-8217
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | JASON C ZAVESKY
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Credential |
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Telephone | 631-445-8217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 288689
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License Number State | NY
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