Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ltc Provider Management Corp

Organization Skilled Nursing Facility · NPI 1346694502

Ltc Provider Management Corp is a Skilled Nursing Facility in Port Washington, New York. Licensed in New York. Registered with an NPI since 2016.

Licensed in
NY
In the registry since
2016
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

30 Wood Rd
Port Washington, NY 11050-2625
Phone: (516) 652-7647
Fax: (516) 944-2385
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 129224 (NY)

Record details

NPI number1346694502
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Myles Gombert — President · (516) 652-7647
NPI enumeratedApril 14, 2016
Last updated in NPPESMarch 27, 2017
Mailing address30 Wood Rd, Port Washington, NY 11050-2625

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