| NPI | 1992901722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE AQUINO Executive Director 631-444-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY SBH00A09585) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: NY CH00A09236) |
| 261QH0100X Clinic/Center, Health Services (Licence: NY RH00A09372) | |
| 261QH0100X Clinic/Center, Health Services (Licence: NY PJ00A09705) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2014-11-18 |