MEDICARE: OCEAN BREEZE 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	3336S0011X	Specialty Pharmacy	027787	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2068218	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912927120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN BREEZE ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	1817 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-1918
Country	:	US
Telephone Number	:	718-987-2525
Fax Number	:	718-987-4316

Provider Business Practice Location Address
First Line	:	1817 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-1918
Country	:	US
Telephone Number	:	718-987-2525
Fax Number	:	718-987-4316

Authorized Official
Title or Position	:	MANAGER
Name	:	SUKETU PATEL
Credential	:	RPH
Telephone Number	:	718-987-2525

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	03/03/2021

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Directions to “OCEAN BREEZE ASSOCIATES LLC ” Practice Location

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