Organization
MARTIN DE PORRES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA LYONS MSW (SOCIAL WORKER)
(516) 502-2840
Entity
Organization
Contact information
Practice address
621 ELMONT ROAD, ELMONT, NY 10003
(516) 502-2840
(516) 502-2841
Mailing address
621 ELMONT RD, ELMONT, NY 11003-4028
(516) 502-2840
(516) 502-2841
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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