Healthcare Provider Details

I. General information

NPI: 1083507685
Provider Name (Legal Business Name): ATD TECHNOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ARBOR FIELD WAY
LAKE GROVE NY
11755-1835
US

IV. Provider business mailing address

4 ARBOR FIELD WAY
LAKE GROVE NY
11755-1835
US

V. Phone/Fax

Practice location:
  • Phone: 631-463-7000
  • Fax: 631-615-6501
Mailing address:
  • Phone: 631-463-7000
  • Fax: 631-615-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MERZENA RAGHURAI
Title or Position: PRESIDENT AND FOUNDER
Credential:
Phone: 631-463-7000