Organization
DEPT. OF HEALTH
Active
Other names
suffolk county
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH PATRICK MARTONE (REGISTERED NURSE)
(631) 853-7373
Entity
Organization
Contact information
Practice address
200 WIRELESS BLVD, HAUPPAUGE, NY 11788-3933
(631) 853-7373
(631) 853-7380
Mailing address
160 CHERRY LN, MEDFORD, NY 11763-4022
(631) 447-1288
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
376106-1
NY
Other
Enumeration date
03/30/2007
Last updated
08/08/2008
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