MEDICARE: MEADOWS FAMILY COUNSELING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1538265806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEADOWS FAMILY COUNSELING INC

Provider Business Mailing Address
First Line	:	27010 GRAND CENTRAL PKWY
Second Line	:	APT. 16T
City	:	FLORAL PARK
State	:	NY
Zip	:	11005-1145
Country	:	US
Telephone Number	:	516-567-1313
Fax Number	:	516-334-6222

Provider Business Practice Location Address
First Line	:	27010 GRAND CENTRAL PKWY
Second Line	:	APT. 16T
City	:	FLORAL PARK
State	:	NY
Zip	:	11005-1145
Country	:	US
Telephone Number	:	516-567-1313
Fax Number	:	516-334-6222

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL PAUL KREMIN
Credential	:	PHD
Telephone Number	:	516-333-4066

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	12/02/2016

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