Organization
ADVANTAGE CARE DIAGNOSTIC AND TREATMENT CENTER ,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RACHELE D MOISE (CLINIC BILLING MANAGER)
(516) 626-1075
Entity
Organization
Contact information
Practice address
189 WHEATLEY RD, BROOKVILLE, NY 11545
(516) 626-1075
(516) 396-9766
Mailing address
189 WHEATLEY RD, BROOKVILLE, NY 11545-2641
(516) 626-1075
(516) 396-9766
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02661801
—
NY
Enumeration date
11/27/2006
Last updated
08/21/2018
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