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General NPI Number Information
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NPI Number | 1740071182
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Entity Type | Organization
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Legal Business Name | OPERATION ENGAGE PSYCHIATRIC SERVICES
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1641 ROUTE 112 STE C
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City | MEDFORD
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State | NY
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Zip | 11763-3663
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Country | US
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Telephone | 631-730-5457
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Fax | 631-803-4242
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Provider Business Mailing Address
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Address Line | 39 WOODBURY RD
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City | FARMINGVILLE
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State | NY
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Zip | 11738-2318
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Country | US
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Telephone | 631-317-2872
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Fax | 661-241-9567
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KAREN NELSON
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Credential |
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Telephone | 631-317-2872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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