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Organization

CSEDNY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BRENDA SPORN RN (NURSE)
(516) 481-0052
Entity
Organization

Contact information

Practice address
175 FULTON AVE, HEMPSTEAD, NY 11550-3718
(516) 481-0052
Mailing address
509 JARVIS AVE, FAR ROCKAWAY, NY 11691-5442

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
584123-1
NY

Other

Enumeration date
08/17/2010
Last updated
08/17/2010
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