Central Suffolk Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5155000N Issued in NY

Legal business name

CENTRAL SUFFOLK HOSPITAL

Doing business as

Peconic Bay Skilled Nursing Facility

Practice address

1300 Roanoke Ave
Riverhead, NY 11901-2031

Phone

(631) 548-6000

Fax

(631) 548-6007

NPI assigned

May 25, 2006

Last updated

Jan 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ronald McManus

Title

VP of Operations

Phone

(631) 548-6071

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Peconic Bay Skilled Nursing Facility Doing business as

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1114973856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012031",
            "telephone_number": "631-548-6000",
            "fax_number": "631-548-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012031",
            "telephone_number": "631-548-6000",
            "fax_number": "631-548-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL SUFFOLK HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "MCMANUS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "631-548-6071",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5155000N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01040922",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "009459",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peconic Bay Skilled Nursing Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cea Speech Language Pathology
• Cea Speech-Language Pathology, PLLC
• Veronica Cea, M.S. CCC/SLP
• Alexis Marie Celentano, MS CCC-SLP
• Central Suffolk Hospital (Peconic Bay Medical Center Professional Group Practice)
• Central Suffolk Hospital (Peconic Bay Medical Center)
• Central Suffolk Hospital (Peconic Bay Medical Center)
• Central Suffolk Hospital (Peconic Bay Homehealth Services)
• Central Suffolk Hosptial (Peconic Bay Medical Center)
• Julian Cereghini, M.D.

• Skilled Nursing Facility in Riverhead, NY
• Providers in Riverhead, 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 Jan 20, 2015; 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.