Self Employed

Skilled Nursing Facility · Mastic Beach, NY

Organization Active NPI

NPI number 1033582291

Practice location

74 Mill Dr
Mastic Beach, NY 11951-1403
Phone
(631) 599-8372

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NPI record

NPI
1033582291
Entity type
Organization (Type 2)
Enumeration date
November 9, 2015
Last updated
November 9, 2015
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X 705976-1 NY

Mailing address

67 Radburn Dr
Farmingville, NY 11738-1046

Authorized official

Name
Ms. Kaitlyn Symancyk
Title
Registered Nurse
Phone
(631) 235-8057

About Self Employed

Self Employed is a healthcare organization registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 74 Mill Dr, Mastic Beach, NY 11951-1403. The NPI number 1033582291 was assigned on November 9, 2015 and the record was last updated on November 9, 2015.

Self Employed lists a license in the registry: #705976-1 (NY) for Skilled Nursing Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Ms. Kaitlyn Symancyk, Registered Nurse.

Frequently asked questions

What is the NPI number of Self Employed?

The NPI number is 1033582291.

What is the phone number of Self Employed?

The phone number listed for the practice location is (631) 599-8372.

Where is Self Employed located?

74 Mill Dr, Mastic Beach, NY 11951-1403.

What is the taxonomy code for Self Employed?

The primary taxonomy code is 314000000X – Skilled Nursing Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.