Provider Demographics
NPI:1952383291
Name:BAYVIEW MANOR LLC
Entity Type:Organization
Organization Name:BAYVIEW MANOR LLC
Other - Org Name:BAYVIEW NURSING& REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-432-0300
Mailing Address - Street 1:1 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:ISLAND PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11558-2254
Mailing Address - Country:US
Mailing Address - Phone:516-432-0300
Mailing Address - Fax:516-432-1204
Practice Address - Street 1:1 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:ISLAND PARK
Practice Address - State:NY
Practice Address - Zip Code:11558-2254
Practice Address - Country:US
Practice Address - Phone:516-432-0300
Practice Address - Fax:516-432-1204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2961302N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00907020Medicaid
NY335162Medicare ID - Type Unspecified