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Organization
COUNTY OF SUFFOLK
Active
Organization
COUNTY OF SUFFOLK
Active
Other names
METHADONE MAINTENANCE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGSON PIGOTT (COMMISSIONER)
(631) 854-0100
Entity
Organization
Contact information
Practice address
300 CENTER DR, RIVERHEAD, NY 11901-3393
(631) 852-2680
(631) 852-2674
Mailing address
3500 SUNRISE HWY, SUITE 124, PO BOX 9006, GREAT RIVER, NY 11739-1001
(631) 854-0100
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
060910393
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473170
—
NY
Enumeration date
09/08/2006
Last updated
07/10/2020
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