Peninsula General Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

7003308N Issued in NY

Legal business name

PENINSULA GENERAL NURSING HOME

Practice address

50-15 Beach Channel Drive
Far Rockaway, NY 11691

Phone

(718) 734-2000

NPI assigned

Jun 20, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Alexander Skutzka

Title

Administrator

Phone

(718) 734-2000

Specialties & licenses 1

Addresses

Other identifiers 2

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Adult Day Health Care

  • Adult Day Care Clinic/Center
  • Far Rockaway, NY
  • NPI 1144476565
  NPPES parent name

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1114922689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50-15 BEACH CHANNEL DRIVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-734-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50-15 BEACH CHANNEL DRIVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-734-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA GENERAL NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "SKUTZKA",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-734-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7003308N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUECROSS",
            "identifier": "00796",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00332834",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice M. Pawliw, R.D., C.D.N.
• Moises Payero, LMT
• Kristyn Pecsi, M.D.
• Peninsula Cardiology, PC
• Peninsula Continuum Services LLC
• Peninsula Hospital Center
• Peninsula Hospital Center
• Peninsula Hospital Center
• Peninsula Hospital Center
• Peninsula Medical Services PC

• Skilled Nursing Facility in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.