Organization
EAST END DISABILITY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES W MARTINSEN (CFO)
(631) 369-7345
Entity
Organization
Contact information
Practice address
107 ROANOKE AVE, RIVERHEAD, NY 11901-2700
(631) 369-7345
(631) 369-7346
Mailing address
107 ROANOKE AVE, RIVERHEAD, NY 11901-2700
(631) 369-7345
(631) 369-7346
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01933095
—
NY
05
—
01998269
—
NY
05
—
02252853
—
NY
05
—
02259709
—
NY
05
—
02594127
—
NY
05
—
02663963
—
NY
05
—
02698406
—
NY
Enumeration date
06/07/2007
Last updated
08/22/2020
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