Organization
MARTIN DE PORRES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD DANA (DIRECTOR OF RELATED SERVICES)
(516) 502-2840
Entity
Organization
Contact information
Practice address
621 ELMONT RD, ELMONT, NY 11003-4028
(516) 502-2840
Mailing address
621 ELMONT RD, ELMONT, NY 11003-4028
(516) 502-2840
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
6455725
NY
Other
Enumeration date
10/21/2010
Last updated
10/21/2010
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