Provider Demographics
NPI:1568452548
Name:OCEANVIEW NURSING & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:OCEANVIEW NURSING & REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLCOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-471-6000
Mailing Address - Street 1:315 BEACH 9TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5507
Mailing Address - Country:US
Mailing Address - Phone:718-471-6000
Mailing Address - Fax:718-327-8950
Practice Address - Street 1:315 BEACH 9TH STREET
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5507
Practice Address - Country:US
Practice Address - Phone:718-471-6000
Practice Address - Fax:718-327-8980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003354N314000000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05246OtherLNHA
NY00310563Medicaid
NY335168Medicare ID - Type Unspecified