Provider Demographics
NPI:1376647826
Name:COUNTY OF ROCKLAND
Entity Type:Organization
Organization Name:COUNTY OF ROCKLAND
Other - Org Name:SUMMIT PARK NURSING CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMMISSIONER OF HOSPITALS
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:845-364-2700
Mailing Address - Street 1:50 SANITORIUM RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3555
Mailing Address - Country:US
Mailing Address - Phone:845-364-2000
Mailing Address - Fax:845-364-2719
Practice Address - Street 1:50 SANITORIUM RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3555
Practice Address - Country:US
Practice Address - Phone:845-364-2000
Practice Address - Fax:845-364-2719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4353000N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00314118Medicaid
NY00314118Medicaid
W78931Medicare Oscar/Certification