Surfside Manor Hfa Lhcsa

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1150L001 Issued in NY

Legal business name

SURFSIDE MANOR HFA LHCSA

Practice address

214 Beach 96TH St
Rockaway Beach, NY 11693-1338

Phone

(718) 713-0004

Fax

(718) 713-0008

NPI assigned

Jan 12, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marcia Morgan-Parker, RN

Title

Administrator

Phone

(718) 713-0004

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ExtraCare Home Care Agency Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1104063270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BEACH 96TH ST",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "116931338",
            "telephone_number": "718-713-0004",
            "fax_number": "718-713-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BEACH 96TH ST",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "116931338",
            "telephone_number": "718-713-0004",
            "fax_number": "718-713-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURFSIDE MANOR HFA LHCSA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "MORGAN-PARKER",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-713-0004",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "1150L001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "1150L001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ExtraCare Home Care Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Rockaway Beach, NY
• Providers in Rockaway Beach, NY by specialty
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.