Sunnyside Manor Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

13A015 Issued in NJ

Legal business name

SUNNYSIDE MANOR INC

Practice address

2500 Ridgewood Rd
Wall Township, NJ 07719-9600

Phone

(732) 528-9311

Fax

(732) 528-9026

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Maryellen Keane, LNHA, CPA

Title

Administrator

Phone

(732) 528-9311

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunnyside Manor Doing business as

Tax ID family

Sunnyside Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sunnyside Manor Inc

  • Skilled Nursing Facility
  • Wall Township, NJ
  • NPI 1417093501
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeana Hansen

  • Nursing Facility/Intermediate Care Facility
  • Manasquan, NJ
  • NPI 1891125175
  NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1750427282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 RIDGEWOOD ROAD",
            "city": "WALL",
            "state": "NJ",
            "postal_code": "07719",
            "telephone_number": "732-528-9311",
            "fax_number": "732-528-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 RIDGEWOOD RD",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199600",
            "telephone_number": "732-528-9311",
            "fax_number": "732-528-9026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Ramshorn Dr",
            "address_purpose": "LOCATION",
            "city": "Manasquan",
            "state": "NJ",
            "postal_code": "087362133",
            "country_code": "US",
            "telephone_number": "732-528-9311",
            "fax_number": "732-528-9026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNNYSIDE MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KEANE",
        "authorized_official_first_name": "MARYELLEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-528-9311",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LNHA, CPA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "13A015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902514",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunnyside Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caroline Steward, RN, APN
• Summit Medical Group PA
• Summit Medical Group PA
• Sunil Asnani, M.D. L.L.C.
• Sunnyside Manor Inc
• Sushil K Mehandru MD PA
• Suvita Medical Aesthetics, PC
• SZR Wall Assisted Living, LLC
• Florence L Tashjian, PT
• Sheryl Teitelbaum

• Assisted Living Facility in Wall Township, NJ
• Providers in Wall Township, NJ by specialty
• Assisted Living Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.