| NPI | 1437889029 |
|---|---|
| Former Legal Business Name | LONG ISLAND FQHC, INC. |
| Other Name | ROOSEVELT HIGH SCHOOL |
| Entity Type | Organization |
| Authorized Contact | DAVID AARON NEMIROFF CEO, President 516-296-4198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2024-02-14 |