Provider Demographics
NPI: | 1538119011 |
---|---|
Name: | NORTH SEA ASSOCIATES LLC |
Entity type: | Organization |
Organization Name: | NORTH SEA ASSOCIATES LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | MEMBER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | KOLMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 516-869-3700 |
Mailing Address - Street 1: | 64 COUNTY ROAD 39 |
Mailing Address - Street 2: | |
Mailing Address - City: | SOUTHAMPTON |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11968-5215 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-986-7317 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 64 COUNTY ROAD 39 |
Practice Address - Street 2: | |
Practice Address - City: | SOUTHAMPTON |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11968-5215 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-986-7317 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-12 |
Last Update Date: | 2015-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 335850 | Medicare Oscar/Certification |