Healthcare Provider Details

I. General information

NPI: 1467508564
Provider Name (Legal Business Name): BELLMORE MERRICK CHSD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 MEADOWBROOK ROAD
NORTH MERRICK NY
11566
US

IV. Provider business mailing address

1260 MEADOWBROOK ROAD
NORTH MERRICK NY
11566
US

V. Phone/Fax

Practice location:
  • Phone: 516-992-1050
  • Fax: 516-705-0821
Mailing address:
  • Phone: 516-992-1050
  • Fax: 516-705-0821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: DR. HENRY G KIERNAN
Title or Position: SUPERINTENDENT
Credential:
Phone: 516-992-1001