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General NPI Number Information
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NPI Number | 1831307628
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Entity Type | Organization
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Legal Business Name | JOSEPH P. ADDABBO FAMILY HEALTH CENTER, INC.
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 6200 BEACH CHANNEL DRIVE
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City | ARVERNE
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State | NY
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Zip | 11692
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Country | US
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Telephone | 718-945-7150
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Fax | 718-945-2596
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Provider Business Mailing Address
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Address Line | 6200 BEACH CHANNEL DRIVE
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City | ARVERNE
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State | NY
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Zip | 11692
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Country | US
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Telephone | 718-945-7150
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Fax | 718-945-7150
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Authorized Official
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Title or Position | ACTING CEO
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Name | MR. ROBERT FLIEGEL
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Credential |
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Telephone | 718-945-7150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 071513
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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