Organization
NYSARC INC., SUFFOLK CHAPTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA A SHIELDS LMSW (DIRECTOR, CHILDREN'S SERVICES)
(631) 218-4949
Entity
Organization
Contact information
Practice address
45 CROSSWAY E, BOHEMIA, NY 11716-1204
(631) 218-4949
Mailing address
45 CROSSWAY E, BOHEMIA, NY 11716-1204
(631) 218-4949
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
580507999853
NY
Other
Enumeration date
01/26/2007
Last updated
08/22/2020
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