Organization
FEGS FAR ROCKAWAY MNTL HLTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONAS WAIZER PH.D. (CHIEF OPERATING OFFICER)
(212) 366-8024
Entity
Organization
Contact information
Practice address
1600 CENTRAL AVE, FAR ROCKAWAY, NY 11691-4008
(718) 327-1600
(718) 868-4792
Mailing address
315 HUDSON ST, 9TH FL., NEW YORK, NY 10013-1009
(212) 366-8007
(212) 366-8069
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
6287100A
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00257805
—
NY
Enumeration date
06/06/2006
Last updated
04/04/2008
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