| Jcc Of The Greater Five Towns Inc | |
|
207 Grove Ave. Cedarhurst NY 11516 | |
| (516) 569-6733 | |
| (516) 569-6917 |
| Full Name | Jcc Of The Greater Five Towns Inc |
|---|---|
| Speciality | Social Worker |
| Location | 207 Grove Ave., Cedarhurst, New York |
| Authorized Official Name and Position | Robert Daniels (CFO) |
| Authorized Official Contact | 5165696733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jcc Of The Greater Five Towns Inc 207 Grove Ave. Cedarhurst NY 11516 Ph: (516) 569-6733 | Jcc Of The Greater Five Towns Inc 207 Grove Ave. Cedarhurst NY 11516 Ph: (516) 569-6733 |
| NPI Number | 1104870203 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 03/17/2023 |
| Certification Date | 03/17/2023 |
| Medicare PECOS PAC ID | 0143233643 |
|---|---|
| Medicare Enrollment ID | O20060731000267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104870203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0558111 (New York) | Primary |
| Provider Name | Lisa D Barnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346293321 PECOS PAC ID: 0648281006 Enrollment ID: I20060522000132 |
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