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NURSING SERVICE PROVIDER
NPI 1215335823
Custodial Care Facility - Adult Care Home in Bay Shore, NY

Active since December 12, 2014
916 SPUR DR S, BAY SHORE, NY 11706(631) 647-3048 Get Directions Write a Review

NPPES record last updated: December 12, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nursing Service Provider NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NURSING SERVICE PROVIDER (NPI 1215335823) is a healthcare organization registered as an adult care home in Bay Shore, New York and active in the NPI registry since December 2014. The organization lists Emmanuel Philogene, Lpn, as its authorized official.

NPPES Registry Identity

NPI1215335823
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameNURSING SERVICE PROVIDER
Location Address916 SPUR DR SBay Shore, NY 11706-4709
Mailing Address916 Spur Dr SBay Shore, NY 11706-4709 · (631) 647-3048
Phone(631) 647-3048
Organization SubpartNo
Authorized OfficialEmmanuel PhilogeneLpn · (631) 647-3048
Enumeration DateDecember 12, 2014
✔ NPI 1215335823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in NY · 312239-1
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
916 SPUR DR S, Bay Shore, NY 11706
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Other Names 1

Doing Business AsNursing Service Provider

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMANUEL PHILOGENE
Licensed Practical Nurse
916 SPUR DR S
BAY SHORE, NY 11706
Suffolk County (631) 336-7055

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nursing Service Provider's NPI number?

The NPI number for Nursing Service Provider is 1215335823. It was assigned to this organization in the NPPES registry on December 12, 2014.

Where is Nursing Service Provider located?

Nursing Service Provider is located at 916 Spur Dr S, Bay Shore, NY 11706. The listed phone number is (631) 647-3048.

What is Nursing Service Provider's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Nursing Service Provider was last updated on December 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.