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
- Phone: 516-818-3470
- Fax: 631-543-4558
- Phone: 516-818-3470
- Fax: 631-543-4558
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | 005872 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 005872 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: