Provider Demographics
NPI:1548778210
Name:OPTIMA CARE SMITHTOWN LLC
Entity Type:Organization
Organization Name:OPTIMA CARE SMITHTOWN LLC
Other - Org Name:BROOKSIDE MULTICARE NURSING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZHANSKYY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-471-7700
Mailing Address - Street 1:7 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1626
Mailing Address - Country:US
Mailing Address - Phone:631-724-2200
Mailing Address - Fax:
Practice Address - Street 1:7 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1626
Practice Address - Country:US
Practice Address - Phone:718-471-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care