Avalon Gardens Rehabilitation and Health Care Center,LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5157313N Issued in NY

Legal business name

AVALON GARDENS REHABILITATION AND HEALTH CARE CENTER,LLC

Practice address

7 Route 25a
Smithtown, NY 11787-1626

Phone

(631) 724-2200

Fax

(631) 724-2225

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Susan O'Connor

Title

Adminstrator

Phone

(631) 724-2200

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

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

• Muhammad T Khan, M.D.

  • Internal Medicine Physician
  • Coram, NY
  • NPI 1720044258
  NPD (past)
• Louis Scotti, DPM

  • Podiatrist
  • Nesconset, NY
  • NPI 1134199151
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1962552216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871626",
            "telephone_number": "631-724-2200",
            "fax_number": "631-724-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ROUTE 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871626",
            "telephone_number": "631-724-2200",
            "fax_number": "631-724-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON GARDENS REHABILITATION AND HEALTH CARE CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "631-724-2200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5157313N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01061178",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00315059",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loseca Austral, LMSW
• Avalon Gardens
• Avalon Gardens Adult Day Health Care
• Avalon Gardens Rehab and Health Care Center LLC
• Avalon Gardens Rehabilitation & Health Care Ctr LLC
• Nida Azamy
• Farzana Aziz, M.D.
• Kay Azzara, RPA-C
• Sabrina Badolato
• Samuel Baharestani, M.D.

• Skilled Nursing Facility in Smithtown, NY
• Providers in Smithtown, 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 Mar 9, 2018; 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.