MEDICARE: SENIOR NETWORK OPTIONS 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
1	251K00000X	Public Health or Welfare Agency	369068	NY

General Provider Information

NPI Number	:	1558643114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR NETWORK OPTIONS INC

Provider Business Mailing Address
First Line	:	862 WEST BAY DRIVE
Second Line	:
City	:	WEST ISLIP
State	:	NEW YORK
Zip	:	11795
Country	:	UM
Telephone Number	:	631-885-5464
Fax Number	:

Provider Business Practice Location Address
First Line	:	862 W BAY DR
Second Line	:
City	:	WEST ISLIP
State	:	NY
Zip	:	11795-4708
Country	:	US
Telephone Number	:	631-885-5464
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MS. PATRICIA A DURKIN
Credential	:	REGISTERED NURSE,BSN
Telephone Number	:	631-885-5464

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	09/09/2011

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