| Charles Evans Center, Inc | |
|
305 Oser Ave Hauppauge NY 11788-3607 | |
| (516) 622-8888 | |
| (516) 933-1266 |
| Full Name | Charles Evans Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 305 Oser Ave, Hauppauge, New York |
| Authorized Official Name and Position | Carmen Virginia Pocasangre (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5166228888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Evans Center, Inc 857 S Oyster Bay Rd Bethpage NY 11714-1030 Ph: (516) 622-8888 | Charles Evans Center, Inc 305 Oser Ave Hauppauge NY 11788-3607 Ph: (516) 622-8888 |
| NPI Number | 1598299356 |
|---|---|
| Provider Enumeration Date | 04/18/2017 |
| Last Update Date | 07/16/2020 |
| Medicare PECOS PAC ID | 1759695992 |
|---|---|
| Medicare Enrollment ID | O20170511001669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598299356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 2950212R (New York) | Primary |
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