Provider Demographics
NPI:1699297929
Name:EXTENDED CARE PHYSICIANS LLC
Entity type:Organization
Organization Name:EXTENDED CARE PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAWOLOKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-220-5760
Mailing Address - Street 1:3816 OLD SHELL RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4723
Mailing Address - Country:US
Mailing Address - Phone:516-220-5760
Mailing Address - Fax:
Practice Address - Street 1:1801 CAMELOT DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2401
Practice Address - Country:US
Practice Address - Phone:516-220-5760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Single Specialty