Provider Demographics
NPI:1790772150
Name:WHITE OAKS REHABILITATION AND NURSING CENTER
Entity Type:Organization
Organization Name:WHITE OAKS REHABILITATION AND NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MISIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-367-3400
Mailing Address - Street 1:8565 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1804
Mailing Address - Country:US
Mailing Address - Phone:516-367-3400
Mailing Address - Fax:516-692-9627
Practice Address - Street 1:8565 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1804
Practice Address - Country:US
Practice Address - Phone:516-367-3400
Practice Address - Fax:516-692-9627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2952306N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01057372Medicaid
NY01057372Medicaid