Organization
TOWN OF ISLIP
Active
Other names
Access
Organization subpart
No
Provider details
NPI number
Authorized official
DELORES BOCKLET (DIRECTOR)
(631) 224-5330
Entity
Organization
Contact information
Practice address
401 MAIN ST, ISLIP, NY 11751-3560
(631) 224-5330
(631) 224-1206
Mailing address
401 MAIN ST, ROOM 132, ISLIP, NY 11751-3560
(631) 224-5330
(631) 224-1206
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
080611082
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01316081
—
NY
Enumeration date
09/21/2006
Last updated
06/12/2008
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