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NPI Code Detail

MEDICARE: THE LONG ISLAND HOME

MEDICARE: THE LONG ISLAND HOME
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
1314000000XSkilled Nursing Facility

Other Identifiers

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

General Provider Information

NPI Number : 1629065172
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE LONG ISLAND HOME
Provider Business Mailing Address
First Line : 400 SUNRISE HWY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2508
Country : US
Telephone Number : 631-264-4000
Fax Number : 631-396-0025
Provider Business Practice Location Address
First Line : 400 SUNRISE HWY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2508
Country : US
Telephone Number : 631-264-4000
Fax Number : 631-396-0025
Authorized Official
Title or Position : CFO
Name : MS. PATRICIA A. PORTER
Credential :
Telephone Number : 631-608-5107
Provider Enumeration Date : 09/30/2005
Last Update Date : 01/27/2008

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1073500559 — THE LONG ISLAND HOME
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1063400042 — KARAN KUMAR MD
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Directions to “THE LONG ISLAND HOME ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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