Healthcare Provider Details

I. General information

NPI: 1356241137
Provider Name (Legal Business Name): AIMRRA TECHNOLOGIES & INNOVATIONS L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TERRY ST
PATCHOGUE NY
11772-1720
US

IV. Provider business mailing address

1 TERRY ST
PATCHOGUE NY
11772-1720
US

V. Phone/Fax

Practice location:
  • Phone: 631-892-9800
  • Fax: 631-516-4094
Mailing address:
  • Phone: 631-892-9800
  • Fax: 631-516-4094

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: VERTISSHA L WOODS
Title or Position: DIRECTOR OF BUSINESS OPERATIONS
Credential:
Phone: 631-294-6233