| St. Johnland Nursing Center, Inc. | |
|
395 Sunken Meadow Rd Kings Park NY 11754-1000 | |
| (631) 269-5800 | |
| (631) 269-5876 |
| Full Name | St. Johnland Nursing Center, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 395 Sunken Meadow Rd, Kings Park, New York |
| Authorized Official Name and Position | Mary Jean Weber (CEO - ADMINISTRATOR) |
| Authorized Official Contact | 6312695800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Johnland Nursing Center, Inc. 395 Sunken Meadow Rd Kings Park NY 11754-1000 Ph: (631) 269-5800 | St. Johnland Nursing Center, Inc. 395 Sunken Meadow Rd Kings Park NY 11754-1000 Ph: (631) 269-5800 |
| NPI Number | 1336219658 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9234028929 |
|---|---|
| Medicare Enrollment ID | O20040311000863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336219658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 5157311N (New York) | Primary |
| Provider Name | Jacques L Winter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750469052 PECOS PAC ID: 5698733012 Enrollment ID: I20041230000504 |
| Provider Name | Max C Rudansky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649358938 PECOS PAC ID: 3577521996 Enrollment ID: I20041230000526 |
| Provider Name | Hillary Diamond |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902967011 PECOS PAC ID: 1052362639 Enrollment ID: I20050201001009 |
| Provider Name | Alex Czira |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871557785 PECOS PAC ID: 7315042090 Enrollment ID: I20070425000403 |
| Provider Name | Adrian I Popp |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457306284 PECOS PAC ID: 4284724121 Enrollment ID: I20071217000192 |
| Provider Name | Thomas M Pabon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558440420 PECOS PAC ID: 8325122187 Enrollment ID: I20080303000845 |
| Provider Name | Maureen Orsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154492429 PECOS PAC ID: 4183749583 Enrollment ID: I20100908000717 |
| Provider Name | Marjorie Mombeleur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831154889 PECOS PAC ID: 2365631363 Enrollment ID: I20110106000340 |
Kings Park Primary Medical Care Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 65 Indian Head Rd, Suite 2, Kings Park, NY 11754 Phone: 631-269-0180 Fax: 631-269-0178 | |
Kings Park Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 93 Main St Ste A, Kings Park, NY 11754 Phone: 631-292-2725 Fax: 631-292-2727 | |
Michael Desposito Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 East Northport Road, Kings Park, NY 11754 Phone: 631-269-1148 Fax: 631-269-1149 | |
Kings Park Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 93 Main St, Suite A, Kings Park, NY 11754 Phone: 631-292-2725 Fax: 631-292-2727 | |
Best Life Therapy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 66 Primrose Ln, Kings Park, NY 11754 Phone: 631-748-7730 |