Organization
SUPPLEMENTAL HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA INDIG (DIRECTOR OF SCHOOL SERVICES)
(646) 776-5675
Entity
Organization
Contact information
Practice address
551 5TH AVE, SUITE 1923, NEW YORK, NY 10176-0001
(646) 776-5675
Mailing address
9 STONEWELL RD, ROCKVILLE CENTRE, NY 11570-1721
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
791437131
NY
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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