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 OPERATIONS)
(631) 696-4357
Entity
Organization
Contact information
Practice address
727 N BROADWAY STE B1, MASSAPEQUA, NY 11758-2348
(631) 696-4357
Mailing address
100 GRANNY RD STE 1, FARMINGVILLE, NY 11738-2879
(631) 696-4357
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
04/05/2020
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