MEDICARE: ROCKAWAY OPERATIONS ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	7003416N	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225578586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKAWAY OPERATIONS ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	4770 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10470-1104
Country	:	US
Telephone Number	:	718-931-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	13-11 VIRGINIA ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-4630
Country	:	US
Telephone Number	:	718-327-2909
Fax Number	:	718-327-7504

Authorized Official
Title or Position	:	MEMBER
Name	:	KENNETH ROZENBERG
Credential	:
Telephone Number	:	718-931-9700

Provider Enumeration Date	:	03/06/2017
Last Update Date	:	05/17/2017

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