Provider Demographics
NPI:1679863393
Name:THE ROSALIND AND JOSEPH GURWIN JEWISH GERIATRIC CENTER OF LONG ISLAND
Entity Type:Organization
Organization Name:THE ROSALIND AND JOSEPH GURWIN JEWISH GERIATRIC CENTER OF LONG ISLAND
Other - Org Name:LONG TERM HOME HEALTH CARE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VITERITTI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:631-715-2511
Mailing Address - Street 1:68 HAUPPAUGE RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4403
Mailing Address - Country:US
Mailing Address - Phone:631-715-2600
Mailing Address - Fax:631-715-2908
Practice Address - Street 1:68 HAUPPAUGE RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4403
Practice Address - Country:US
Practice Address - Phone:631-715-2600
Practice Address - Fax:631-715-2908
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ROSALIND AND JOSEPH GURWIN JEWISH GERIATRIC CENTER OF LONG ISLAND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-14
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5157903251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01733600Medicaid
NY01733600Medicaid