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 OPS)
(631) 696-4357
Entity
Organization
Contact information
Practice address
2 CORACI BLVD STE 15, SHIRLEY, NY 11967-4833
(631) 696-4357
(631) 846-8138
Mailing address
100 GRANNY RD STE 1, FARMINGVILLE, NY 11738-2879
(631) 696-4357
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/11/2020
Last updated
01/11/2020
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