Healthcare Provider Details

I. General information

NPI: 1164695243
Provider Name (Legal Business Name): TOWN OF HUNTINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 PARK AVE
HUNTINGTON NY
11743-2803
US

IV. Provider business mailing address

423 PARK AVE
HUNTINGTON NY
11743-2803
US

V. Phone/Fax

Practice location:
  • Phone: 631-351-3293
  • Fax: 631-351-3221
Mailing address:
  • Phone: 631-351-3293
  • Fax: 631-351-3221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN J. HARTY II
Title or Position: DIRECTOR OF SENIOR CITIZENS DIVISIO
Credential:
Phone: 631-351-3253