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General NPI Number Information
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NPI Number | 1558643114
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Entity Type | Organization
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Legal Business Name | SENIOR NETWORK OPTIONS INC
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 862 W BAY DR
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City | WEST ISLIP
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State | NY
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Zip | 11795-4708
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Country | US
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Telephone | 631-885-5464
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Fax |
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Provider Business Mailing Address
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Address Line | 862 WEST BAY DRIVE
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City | WEST ISLIP
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State | NEW YORK
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Zip | 11795
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Country | UM
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Telephone | 631-885-5464
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. PATRICIA A DURKIN
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Credential | REGISTERED NURSE,BSN
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Telephone | 631-885-5464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 369068
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License Number State | NY
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