| Eating Disorder Treatment Of New York, Llc | |
|
254 Bread And Cheese Hollow Rd Northport NY 11768-2606 | |
| (631) 540-0980 | |
| (631) 967-1667 |
| Full Name | Eating Disorder Treatment Of New York, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 254 Bread And Cheese Hollow Rd, Northport, New York |
| Authorized Official Name and Position | Edward Moody (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5713343144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eating Disorder Treatment Of New York, Llc 6100 Sw 76th St South Miami FL 33143-5002 Ph: (305) 663-1876 | Eating Disorder Treatment Of New York, Llc 254 Bread And Cheese Hollow Rd Northport NY 11768-2606 Ph: (631) 540-0980 |
| NPI Number | 1699528950 |
|---|---|
| Provider Enumeration Date | 04/08/2024 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699528950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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