Organization
AWIXA HOME OF LI, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALYSE ROBIN CARDELLO (CEO)
(516) 882-9492
Entity
Organization
Contact information
Practice address
199 BENTON PL, BAY SHORE, NY 11706-1507
(516) 882-9492
(516) 882-9494
Mailing address
301 CLEARVIEW LN, MASSAPEQUA, NY 11758-8505
(516) 882-9492
(516) 882-9494
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
NY
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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