# WINTHROP COMMUNITY MEDICAL AFFILIATES PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NYU Winthrop Diabetes Self-Management Program
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245724152
- **Authorized official:** BRIAN SADOWSKY (CREDENTIALING MANAGER)
- **Authorized official phone:** (516) 663-8919

## Contact information

- **Practice address:** 101 MINEOLA BLVD STE 210, MINEOLA, NY 11501-4089
- **Practice address phone:** (516) 663-3511
- **Mailing address:** 700 HICKSVILLE RD STE 204, BETHPAGE, NY 11714-3472

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | — | NULL | Yes |
| 174H00000X | Health Educator | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2018
- **Last updated:** 06/15/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04867401 | — | NY |