Park Inn Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

PARK INN HOME

Practice address

11502 Ocean Promenade
Rockaway Park, NY 11694-2412

Phone

(718) 634-3400

NPI assigned

Nov 10, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Grajales

Title

Director of Special Projects

Phone

(347) 988-4535

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1760190599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2357 60TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11502 OCEAN PROMENADE",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942412",
            "telephone_number": "718-634-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK INN HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "GRAJALES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR OF SPECIAL PROJECTS",
        "authorized_official_telephone_number": "347-988-4535"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Park Nursing Home
• Marcy Parker, RN
• Rownak Kumara Paspulati Saibaba, PT
• Katie Marie Pastina
• Gregory Patrizio, OD

• Adult Care Home Facility in Rockaway Park, NY
• Providers in Rockaway Park, NY by specialty
• Adult Care Home Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.