Provider Demographics
NPI:1487392601
Name:NASSAU HEALTH CARE CORPORATION
Entity type:Organization
Organization Name:NASSAU HEALTH CARE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING ENROLLMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVANAGH-LANTIMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-572-5135
Mailing Address - Street 1:2201 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1859
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:875 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3038
Practice Address - Country:US
Practice Address - Phone:516-572-1510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NASSAU HEALTH CARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility