Provider Demographics
NPI:1841322435
Name:S & L BIRCHWOOD LLC
Entity type:Organization
Organization Name:S & L BIRCHWOOD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-423-3200
Mailing Address - Street 1:78 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3922
Mailing Address - Country:US
Mailing Address - Phone:631-423-3200
Mailing Address - Fax:631-673-5869
Practice Address - Street 1:78 BIRCHWOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3922
Practice Address - Country:US
Practice Address - Phone:631-423-3200
Practice Address - Fax:631-673-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00309513Medicaid
NYB12533Medicare UPIN
NYA64502Medicare UPIN
NYH69376Medicare UPIN
NY6069350001Medicare NSC
NYA62329Medicare UPIN
NYM90690Medicare UPIN
NYB20640Medicare UPIN
NYE84287Medicare UPIN
NYH94162Medicare UPIN
NY00309513Medicaid