Jopal Sayville

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

JOPAL SAYVILLE

Doing business as

Sayville Nursing and Rehabilitation Center

Practice address

300 Broadway Ave
Sayville, NY 11782-1628

Phone

(631) 567-9300

NPI assigned

Dec 27, 2012

Organization subpart

No

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

Authorized official

Name

Anthony Derosa

Title

VP of Finance

Phone

(516) 422-7817

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sayville Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486684800000",
    "number": "1225374911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972054",
            "telephone_number": "516-422-7817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BROADWAY AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821628",
            "telephone_number": "631-567-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOPAL SAYVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2017-02-10",
        "status": "A",
        "authorized_official_last_name": "DEROSA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "516-422-7817"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01374230",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sayville Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Jacobs
• James Paul Dinovis
• Jason Intermesoli DPT PLLC
• Jennifer Flanagan LCSW, PC
• Judith A. Johnsen, MSW
• Johanne M. Judd, D.C.
• Nicole Just
• Mary Alice Kacinski, R.N.
• Georgios Katsamanis, RPH
• Kelly Christina Kavanagh, LMSW

• Skilled Nursing Facility in Sayville, NY
• Providers in Sayville, 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 Feb 10, 2017; 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.