Park Shore Healthcare Center, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0601302N Issued in NY

Legal business name

PARK SHORE HEALTHCARE CENTER, INC

Practice address

447 Lake Shore Dr W
Dunkirk, NY 14048-1479

Phone

(716) 366-6710

Fax

(716) 366-7116

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Smith

Title

Treasurer

Phone

(716) 805-1474

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• The Waters of Dunkirk Doing business as

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1326087784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GLEED AVE",
            "address_2": "THE PARK ASSOCIATES, INC",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522980",
            "telephone_number": "716-652-2820",
            "fax_number": "716-655-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 LAKE SHORE DR W",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140481479",
            "telephone_number": "716-366-6710",
            "fax_number": "716-366-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SHORE HEALTHCARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "716-805-1474",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "0601302N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00011474601",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01058759",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "000000308000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "4U",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Waters of Dunkirk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marion Wiemer Oliva, RPH
• John F. Orosz, MD
• Joel Ortiz
• Rachel Orzechowski, MS, OTR/L
• Rajiv C Parikh, M.D.
• Drutika S Patel, PA-C
• Taylor Patterson
• Jennifer Lee Pattyson, M.S. SPEECH PATH
• Suzanne Paul, CRT
• Joshua Michael Pavlovich, PA

• Skilled Nursing Facility in Dunkirk, NY
• Providers in Dunkirk, 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 Aug 1, 2008; 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.