Organization
GOOD SAMARITAN HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELIZABETH MARION JAQUAY MSOTR/L (OCCUPATIONAL THERAPIST)
(631) 376-3076
Entity
Organization
Contact information
Practice address
1000 MONTAUK HIGHWAY, WEST ISLIP, NY 11795
(631) 376-3069
Mailing address
1000 MONTAUK HIGHWAY, WEST ISLIP, NY 11795
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
0160601
NY
Other
Enumeration date
05/06/2011
Last updated
05/06/2011
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