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Organization

ROOSEVELT CHILDRENS CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DIANE M. PETERS REGISTERED NURSE (REGISTERED NURSE)
(315) 331-5001
Entity
Organization

Contact information

Practice address
848 PEIRSON AVENUE, NEWARK N, NY 14513-9762
(315) 331-2086
Mailing address
848 PEIRSON AVENUE, NEWARK N, NY 14513-9762
(315) 331-2086

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
444295-1
NY

Other

Enumeration date
10/06/2008
Last updated
10/06/2008
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