Organization
DEPARTMENT OF VETERANS AFFAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JINNY ANNE MULLEN CTRS (RECREATION THERAPIST)
(631) 261-4400
Entity
Organization
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46698
RECREATION THERAPIST
NY
Enumeration date
08/31/2006
Last updated
10/06/2008
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