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1 Alexander Pl Glen Cove NY 11542-3745 | |
| (516) 759-1844 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1 Alexander Pl, Glen Cove, New York |
| Authorized Official Name and Position | Robert J Mcmahon (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5167591844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1 Alexander Place Glen Cove NY 11542 Ph: (516) 759-1844 | 1 Alexander Pl Glen Cove NY 11542-3745 Ph: (516) 759-1844 |
| NPI Number | 1891979134 |
|---|---|
| Provider Enumeration Date | 12/21/2007 |
| Last Update Date | 12/21/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891979134 | NPI | - | NPPES |
| 00675530 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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