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General NPI Number Information
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NPI Number | 1376073908
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Entity Type | Organization
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Legal Business Name | TOWN OF SOUTHAMPTON
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 06/15/2017
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Provider Practice Location Address
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Address Line | 25 PONQUOGUE AVE
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City | HAMPTON BAYS
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State | NY
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Zip | 11946
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Country | US
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Telephone | 631-728-1235
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Fax | 631-723-3061
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Provider Business Mailing Address
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Address Line | P.O. BOX 974
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City | HAMPTON BAYS
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State | NY
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Zip | 11946
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Country | US
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Telephone | 631-728-1235
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Fax | 631-723-3061
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Authorized Official
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Title or Position | TOWN MGT. SERVICES ADMINISTER
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Name | MR. RUSSELL KRATOVILLE
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Credential |
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Telephone | 631-702-1909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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