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General NPI Number Information
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NPI Number | 1790653236
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Entity Type | Organization
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Legal Business Name | CS MEDICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 64 BROADWAY
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City | AMITYVILLE
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State | NY
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Zip | 11701-2702
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Country | US
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Telephone | 631-696-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 1377 MOTOR PKWY STE 102
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City | ISLANDIA
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State | NY
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Zip | 11749-5249
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP OPS
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Name | TRACEY WALLACE
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Credential |
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Telephone | 631-696-4357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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