Organization
CS MEDICAL ASSOCIATES, P.C.
Active
Parent organization
CS MEDICAL ASSOCIATES, P.C.
Other names
Victory Recovery Partners
Organization subpart
Yes
Provider details
NPI number
Legal business name
CS MEDICAL ASSOCIATES, P.C.
Authorized official
TRACEY WALLACE (VP OPERATIONS)
(631) 696-4357
Entity
Organization
Contact information
Practice address
120 BETHPAGE RD STE 101, HICKSVILLE, NY 11801-1515
(631) 696-4357
Mailing address
100 GRANNY RD, FARMINGVILLE, NY 11738-2879
(631) 696-4357
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05150629
—
NY
Enumeration date
11/02/2022
Last updated
11/02/2022
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