Organization
TOWN OF SOUTHAMPTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL KRATOVILLE (TOWN MGT. SERVICES ADMINISTER)
(631) 702-1909
Entity
Organization
Contact information
Practice address
25 PONQUOGUE AVE, HAMPTON BAYS, NY 11946
(631) 728-1235
(631) 723-3061
Mailing address
P.O. BOX 974, HAMPTON BAYS, NY 11946
(631) 728-1235
(631) 723-3061
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2017
Last updated
06/15/2017
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