Provider Demographics
NPI:1013400258
Name:MEADOW PARK OPERATOR LLC
Entity Type:Organization
Organization Name:MEADOW PARK OPERATOR LLC
Other - Org Name:MEADOW PARK REHABILITATION AND HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:
Authorized Official - First Name:YITZCHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROKOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-903-1958
Mailing Address - Street 1:635 DUQUESNE BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-5073
Mailing Address - Country:US
Mailing Address - Phone:732-903-1958
Mailing Address - Fax:
Practice Address - Street 1:1525 N ROLLING RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1100
Practice Address - Country:US
Practice Address - Phone:410-402-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit