Provider Demographics
NPI:1639167935
Name:A.FEUEREISEN &L. SZANTO PTR
Entity Type:Organization
Organization Name:A.FEUEREISEN &L. SZANTO PTR
Other - Org Name:FAR ROCKAWAY NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARON
Authorized Official - Middle Name:
Authorized Official - Last Name:FEUEREISEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-327-2909
Mailing Address - Street 1:1311 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4630
Mailing Address - Country:US
Mailing Address - Phone:718-327-2909
Mailing Address - Fax:718-327-7504
Practice Address - Street 1:13-11 VIRGINIA STREET
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4630
Practice Address - Country:US
Practice Address - Phone:718-327-2909
Practice Address - Fax:718-327-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003315N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY335044Medicare Oscar/Certification