Provider Demographics
NPI:1275824377
Name:OCEAN BREEZE ASSOCIATES L L C
Entity Type:Organization
Organization Name:OCEAN BREEZE ASSOCIATES L L C
Other - Org Name:OCEAN BREEZE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUKETU
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-987-2525
Mailing Address - Street 1:235 DONGAN HILLS AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1224
Mailing Address - Country:US
Mailing Address - Phone:718-979-5326
Mailing Address - Fax:718-979-6109
Practice Address - Street 1:235 DONGAN HILLS AVE STE 2B
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1224
Practice Address - Country:US
Practice Address - Phone:800-219-5920
Practice Address - Fax:800-219-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030618333600000X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2130003OtherPK