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Organization

BROOKHAVEN FAMILY MEDICINE

Active
Parent organization
BROOKHAVEN FAMILY MEDICINE
Organization subpart
Yes

Provider details

NPI number
Legal business name
BROOKHAVEN FAMILY MEDICINE
Authorized official
MRS. LINDA ELLEN MILLEISEN LCSW-R (PSYCHOTHERAPIST)
(631) 447-3036
Entity
Organization

Contact information

Practice address
100 HOSPITAL ROAD, PATCHOGUE, NY 11772
(631) 687-6900
(631) 447-5954
Mailing address
101 HOSPITAL ROAD, PATCHOGUE, NY 11772
(631) 447-3036
(631) 447-3053

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
NY

Other

Enumeration date
05/02/2013
Last updated
05/02/2013
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