Park Nursing Home

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

PARK NURSING HOME

Practice address

128 Beach 115 Street
Rockaway Park, NY 11694

Phone

(718) 474-6400

Fax

(718) 474-9669

NPI assigned

Oct 31, 2005

Last updated

Mar 12, 2008By 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. Patrick Russell

Title

Administrator

Phone

(718) 474-6400

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Andrew Galvin, MD

  • Internal Medicine Physician
  • Rockaway Park, NY
  • NPI 1962588731
  NPD (past)
• Shaya Khabyeh-Hasbani, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1346299047
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1801887898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 BEACH 115 STREET",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "11694",
            "telephone_number": "718-474-6400",
            "fax_number": "718-474-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 BEACH 115 STREET",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "11694",
            "telephone_number": "718-474-6400",
            "fax_number": "718-474-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-474-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312487",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Open Door PT OT, PLLC
• Opop, LLC (Beacon Rehabilitation and Nursing Center)
• Park Ave Psychotherapy
• Park Ave. Psychotherapy Group
• Park Inn Home
• Marcy Parker, RN
• Rownak Kumara Paspulati Saibaba, PT
• Katie Marie Pastina
• Gregory Patrizio, OD
• Keyah Patterson

• Nursing Facility/Intermediate Care Facility in Rockaway Park, NY
• Providers in Rockaway Park, NY by specialty
• Nursing Facility/Intermediate Care Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.