| NPI | 1770813792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDEEP JAIN Medical Director 516-707-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251E00000X Home Health |
| 251S00000X | |
| 261Q00000X Clinic/Center | |
| 261QC1800X Clinic/Center, Corporate Health | |
| 261QE0002X Clinic/Center, Emergency Care | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1000X Clinic/Center, Migrant Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QP2400X Clinic/Center, Prison Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QS1000X Clinic/Center, Student Health | |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2023-06-08 |