1447491725 NPI number — THE ROSALIND AND JOSEPH GURWIN JEWISH GERIATRIC CENTER OF LONG ISLAND

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447491725 NPI number — THE ROSALIND AND JOSEPH GURWIN JEWISH GERIATRIC CENTER OF LONG ISLAND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE ROSALIND AND JOSEPH GURWIN JEWISH GERIATRIC CENTER OF LONG ISLAND
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADULT DAY CARE PROGRAM
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447491725
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
68 HAUPPAUGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COMMACK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11725-4403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-715-2600
Provider Business Mailing Address Fax Number:
631-715-2908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
68 HAUPPAUGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COMMACK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11725-4403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-715-2600
Provider Business Practice Location Address Fax Number:
631-715-2908
Provider Enumeration Date:
03/16/2009

Additional Information

Authorized Official

Authorized Official Last Name:
VITERITTI
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
631-715-2511

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X , with the licence number:  5153307N , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01208882 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03084746 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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