| Martin De Porres | |
|
621 Elmont Road Elmont NY 10003 | |
| (516) 502-2840 | |
| (516) 502-2841 |
| Full Name | Martin De Porres |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 621 Elmont Road, Elmont, New York |
| Authorized Official Name and Position | Patricia Lyons (SOCIAL WORKER) |
| Authorized Official Contact | 5165022840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin De Porres 621 Elmont Rd Elmont NY 11003-4028 Ph: (516) 502-2840 | Martin De Porres 621 Elmont Road Elmont NY 10003 Ph: (516) 502-2840 |
| NPI Number | 1063712347 |
|---|---|
| Provider Enumeration Date | 11/02/2010 |
| Last Update Date | 11/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063712347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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