Healthcare Provider Details

I. General information

NPI: 1699877811
Provider Name (Legal Business Name): SUFFOLK COUNTY DEPT OF HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 CROOKED HILL RD PILGRIM ST PSYCH CTR
BRENTWOOD NY
11717-1043
US

IV. Provider business mailing address

225 RABRO DR
HAUPPAUGE NY
11788-4241
US

V. Phone/Fax

Practice location:
  • Phone: 631-761-4154
  • Fax:
Mailing address:
  • Phone: 631-853-3000
  • Fax: 631-853-2927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. BRIAN L HARPER
Title or Position: COMMISSIONER
Credential: M.D.,M.P.D.
Phone: 631-853-3000