6677 BROADWAY LLC (NPI# 1063010767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063010767 |
| Entity Type | Organization |
| Organization Name | 6677 BROADWAY LLC |
| Practice Address |
140 Beach 119th St Rockaway Park NY 11694-1953 |
| Mailing Address |
4718 18th Ave Ste 26 Brooklyn NY 11204-1260 |
| Practice Telephone | 7189387183 |
| Mailing Telephone | 7189387183 |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |
| Authorized Official Name | ANGELA BORUKHOVA (OFFICE MANAGER) |
| Authorized Official Telephone | 7189387183 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | 6677 BROADWAY LLC | 4718 18th Avenue, Suite 26, Brooklyn, Ny 11204 |
| Street Address |
140 BEACH 119TH ST |
| City | ROCKAWAY PARK |
| State | NY |
| Zip Code | 11694-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235775941 | Shrok Sayed Elsayed | Physical Therapist | 234 Beach 124th St, Rockaway Park, NY 11694 | 2019-11-18 |
| 1730720699 | Mary Kay A Gibbons | Registered Nurse | 1 Beach 105 Street, 12f, Rockaway Park, NY 11694 | 2019-10-02 |
| 1275026684 | Aba Tree | Behavioral Analyst | 142 B120 Street, Rockaway Street, NY 11694 | 2018-06-11 |
| 1235640855 | Rockaways Asc Development, LLC. | Clinic/Center | 105-20 Rockaway Beach Blvd, Suite 301, Rockaway Park, NY 11694 | 2017-10-23 |
| 1841721479 | Mary Mongelli | Behavioral Analyst | 414 Beach124 Street, Belle Harbor, NY 11694 | 2017-03-24 |
| 1033659495 | Tri Center | Community/Behavioral Health | 2488 Grand Concourse Suite 417, Bronx, NY 11694 | 2017-03-06 |
| 1083079446 | Bernadette Favard | Licensed Practical Nurse | 140 Beach 114street, Promenaden Ursing Home, Rockaway Park, NY 11694 | 2015-12-29 |
| 1801231808 | Matthew Tagliavia | Pharmacist | 449 Beach 129th St, Belle Harbor, NY 11694 | 2013-05-03 |
| 1831445436 | Megan Leigh Hill | Social Worker | 140 Beach 112th St, Rockaway Park, NY 11694 | 2012-08-01 |
| 1710241112 | Scott Blutstein | Specialist | 411 Beach 133 Street, Rockaway Park, NY 11694 | 2012-06-29 |
| Find all providers in zip 11694 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217113 | Top Care Ny | Home Health | 13103 Rockaway Beach Blvd, Rockaway Park, NY 11694-1428 | 2020-08-27 |
| 1285298463 | Kimberly L Jenkins I | Home Health | 226 Beach 98th St # 3, Rockaway Park, NY 11694-2849 | 2019-04-24 |
| 1902460843 | Serenity Comfort Care & Family Services | Home Health | 226 Beach 98th St # 3, Rockaway Park, NY 11694-2849 | 2019-04-25 |
| 1396023487 | Occupational Therapy Clubhouse, PC | Home Health | 321 Beach 102nd St, Rockaway Park, NY 11694-2867 | 2011-07-25 |
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| 1821695834 | Rymax Electronics Inc | Home Health | 1805 5th Ave Ste F, Bay Shore, NY 11706-1761 | 2020-10-02 |
| 1003421074 | Massagebywen Pllc | Home Health | 24028 Memphis Ave, Rosedale, NY 11422-2017 | 2020-09-15 |
| 1679188056 | Anchor Home Care, LLC | Home Health | 50 Lakefront Boulevard Suite 200, Buffalo, NY 14202-4301 | 2020-09-11 |
| 1326653197 | Smart Aging LLC | Home Health | 405 Lexington Ave Fl 26, New York, NY 10174-2699 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
| City | ROCKAWAY PARK |
| Zip Code | 11694 |
Please comment or provide details below to improve the information on 6677 BROADWAY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.