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NPI Code Detail

MEDICARE: JUST KIDS DIAGNOSTIC AND TREATMENT CENTER INC

MEDICARE: JUST KIDS DIAGNOSTIC AND TREATMENT CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency5151203RNY
2252Y00000XEarly Intervention Provider Agency5151203RNY
3261Q00000XClinic/Center5151203RNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265570493
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUST KIDS DIAGNOSTIC AND TREATMENT CENTER INC
Provider Business Mailing Address
First Line : 35 LONGWOOD RD
Second Line : P.O. BOX 12
City : MIDDLE ISLAND
State : NY
Zip : 11953-2045
Country : US
Telephone Number : 631-924-0008
Fax Number : 631-924-1243
Provider Business Practice Location Address
First Line : 35 LONGWOOD RD
Second Line :
City : MIDDLE ISLAND
State : NY
Zip : 11953-2045
Country : US
Telephone Number : 631-924-0008
Fax Number : 631-924-1243
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. STEVE M. HELD
Credential : M.A.
Telephone Number : 631-924-0008
Provider Enumeration Date : 02/01/2007
Last Update Date : 12/16/2020

Similar Medicare Providers

1417891391 — MR. TYLER MCMANUS
Practice Location Address:
35 LONGWOOD RD
MIDDLE ISLAND, NY
11953-2045
Practice Phone: 631-924-0008
Practice Fax:
1750226585 — LISA ALEXANDRA RUDOLPH
Practice Location Address:
35 LONGWOOD RD
MIDDLE ISLAND, NY
11953-2045
Practice Phone: 631-924-0008
Practice Fax:
1215871421 — MS. KATE ELIZABETH ANDREWS M.A.
Practice Location Address:
35 LONGWOOD RD
MIDDLE ISLAND, NY
11953-2045
Practice Phone: 516-667-0700
Practice Fax:
1073457297 — KATINA FERRARO
Practice Location Address:
35 LONGWOOD RD
MIDDLE ISLAND, NY
11953-2045
Practice Phone: 631-924-0008
Practice Fax:
1598609646 — MEGAN KATHLEEN MALONE
Practice Location Address:
35 LONGWOOD RD
MIDDLE ISLAND, NY
11953-2045
Practice Phone: 631-924-0008
Practice Fax:
1316915523 — DR. MICHAEL PHILIP RODRIGUEZ MD
Practice Location Address:
35 LONGWOOD RD
MIDDLE ISLAND, NY
11953-2045
Practice Phone: 631-924-1000
Practice Fax:

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