Healthcare Provider Details

I. General information

NPI: 1104075985
Provider Name (Legal Business Name): ARLENE COHEN MORSE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 HORSESHOE LN
COMMACK NY
11725-5507
US

IV. Provider business mailing address

26 HORSESHOE LN
COMMACK NY
11725-5507
US

V. Phone/Fax

Practice location:
  • Phone: 516-818-3470
  • Fax: 631-543-4558
Mailing address:
  • Phone: 516-818-3470
  • Fax: 631-543-4558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number005872
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number005872
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: