Provider First Line Business Practice Location Address:
128 BEACH 115TH STREET
Provider Second Line Business Practice Location Address:
PARK NURSING HOME
Provider Business Practice Location Address City Name:
ROCKAWAY PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11694
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-474-6400
Provider Business Practice Location Address Fax Number:
914-949-1245
Provider Enumeration Date:
07/11/2006