| Sullivan County Department Of Community Services | |
|
20 Community Lane Liberty NY 12754-0716 | |
| (845) 292-8770 | |
| (845) 292-4298 |
| Full Name | Sullivan County Department Of Community Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 20 Community Lane, Liberty, New York |
| Authorized Official Name and Position | Joseph Todora (DIRECTOR) |
| Authorized Official Contact | 8452928770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sullivan County Department Of Community Services Po Box 716 20 Community Lane Liberty NY 12754-0716 Ph: (845) 292-8770 | Sullivan County Department Of Community Services 20 Community Lane Liberty NY 12754-0716 Ph: (845) 292-8770 |
| NPI Number | 1417987165 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 08/07/2008 |
| Medicare PECOS PAC ID | 0143114439 |
|---|---|
| Medicare Enrollment ID | O20040209000841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417987165 | NPI | - | NPPES |
| 12443 | Other | NY | BEACON HEALTH |
| 143247 | Other | NY | VALUE OPTIONS |
| 00398370 | Medicaid | NY | |
| 01147777 | Medicaid | NY | |
| 143247 | Other | NY | GHI |
| Provider Name | Quazi Al-tariq |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124033808 PECOS PAC ID: 4486692308 Enrollment ID: I20050421000340 |
| Provider Name | Zhaniizzha E K Kevii |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114958386 PECOS PAC ID: 3375692247 Enrollment ID: I20090526000036 |
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