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11606 Myrtle Ave Richmond Hill NY 11418-1748 | |
| (718) 215-1952 | |
| (718) 441-3701 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11606 Myrtle Ave, Richmond Hill, New York |
| Authorized Official Name and Position | Stephen Mccarthy (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6316695355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1 Farmingdale Road Route 109 West Babylon NY 11704-6545 Ph: (631) 669-5355 | 11606 Myrtle Ave Richmond Hill NY 11418-1748 Ph: (718) 215-1952 |
| NPI Number | 1023177755 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 08/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023177755 | NPI | - | NPPES |
| 01303882 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 01303882 (New York) | Primary |
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