Organization
AIDS DAY TREATMENT FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN M KENNEDY (CFO)
(516) 733-7000
Entity
Organization
Contact information
Practice address
333 N MAIN ST, FREEPORT, NY 11520-1231
(516) 623-7400
Mailing address
333 N MAIN ST, FREEPORT, NY 11520-1231
(516) 623-7400
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01635336
—
NY
Enumeration date
03/27/2007
Last updated
08/22/2020
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