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General NPI Number Information
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NPI Number | 1801017728
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Entity Type | Organization
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Legal Business Name | NEW PATHWAY
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 111 W OLD COUNTRY RD SUITE 2B
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City | HICKSVILLE
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State | NY
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Zip | 11801-4003
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Country | US
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Telephone | 516-433-6069
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Fax | 516-433-6245
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Provider Business Mailing Address
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Address Line | 111 W OLD COUNTRY RD SUITE 2B
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City | HICKSVILLE
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State | NY
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Zip | 11801-4003
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Country | US
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Telephone | 516-433-6069
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Fax | 516-433-6245
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. GARY BUTCHEN
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Credential | LCSW-R, CASAC, SAP
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Telephone | 516-433-6069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | NY
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