Provider Demographics
NPI:1275521064
Name:OCEANSIDE CARE CENTER INC
Entity Type:Organization
Organization Name:OCEANSIDE CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-592-9200
Mailing Address - Street 1:2914 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2141
Mailing Address - Country:US
Mailing Address - Phone:516-536-2300
Mailing Address - Fax:516-536-2320
Practice Address - Street 1:2914 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2141
Practice Address - Country:US
Practice Address - Phone:516-536-2300
Practice Address - Fax:516-536-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2950314N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00310485Medicaid
NY335158Medicare ID - Type Unspecified