Uscg Sector New York

NPI 1770553752 - Clinic/Center - 261QM1100X

NPI Details
NPI 1770553752
Enumeration Date 01/24/2006
Last Updated 09/24/2010
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name TIMOTHY L. TIMOTHY
Position CLINIC ADMINISTRATOR
Phone (718) 354-4414
Fax (718) 354-4415
Practice Location
215 DRUM ROAD
ROOM D-113
STATEN ISLAND NY, 10305, US
Phone (718) 354-4414
Fax (718) 354-4415
Business Location
215 DRUM ROAD
ROOM D-113
STATEN ISLAND NY, 10305, US
Phone (718) 354-4414
Fax (718) 354-4415
Toxanomy
Taxonomy Code 261QM1100X
License State Virginia
License Number 0101050128
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According to our database, Uscg Sector New York NPI is 1770553752, taxonomy code is 261QM1100X and license number is 0101050128, license state is located at Virginia. Uscg Sector New York physically located at 215 Drum Road, Staten Island NY, 10305. NPI Number 1033115704 has the healthcare provider type.

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1770553752 NPI number is provided on an as is basis without warranty of any kind. 1770553752 is maintained by the National Plan & Provider Enumeration System. The contents of Uscg Sector New York are for informational purposes only.