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General NPI Number Information
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NPI Number | 1841554144
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Entity Type | Organization
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Legal Business Name | UNITED COMPREHENSIVE CARE, LTD
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 170 OLD COUNTRY RD
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City | RIVERHEAD
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State | NY
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Zip | 11901-2198
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Country | US
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Telephone | 631-473-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 170 OLD COUNTRY RD
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City | RIVERHEAD
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State | NY
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Zip | 11901-2198
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Country | US
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Telephone | 631-473-7100
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. KENNETH GAUL
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Credential |
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Telephone | 631-473-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NY
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