Active NPI
Self
- Skilled Nursing Facility
- Amityville, NY
National Provider Identifier
1811334758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 102980029
- Legal business name
- SELF
- Practice address
- 4 Spruce Rd
Amityville, NY 11701-1019 - Phone
- (631) 413-6210
- NPI assigned
- Jun 2, 2013
- Organization subpart
- Yes
- Parent organization
- SELF
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elcie Besse
- Title
- LPN
- Phone
- (631) 413-6210
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 102980029 | NY | Primary |
Addresses
Primary practice location
4 Spruce Rd
Amityville, NY 11701-1019
Mailing address
4 Spruce Rd
Amityville, NY 11701-1019
National Provider Directory
National Provider Directory- Part of
- Self
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1370131200000",
"number": "1811334758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 SPRUCE RD",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117011019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 SPRUCE RD",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117011019",
"telephone_number": "631-413-6210"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SELF",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SELF",
"enumeration_date": "2013-06-02",
"last_updated": "2013-06-02",
"status": "A",
"authorized_official_last_name": "BESSE",
"authorized_official_first_name": "ELCIE",
"authorized_official_title_or_position": "LPN",
"authorized_official_telephone_number": "631-413-6210"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NY",
"license": "102980029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.