Organization
EXTENDACARE INC.
Active
Other names
Medistaf Health & Research
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE A UVEGES (ADMINISTRATOR)
(631) 473-1317
Entity
Organization
Contact information
Practice address
646 MAIN ST, PORT JEFFERSON, NY 11777-2235
(631) 473-1317
(631) 473-1337
Mailing address
646 MAIN ST, PORT JEFFERSON, NY 11777-2235
(631) 473-1317
(631) 473-1337
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
9589L001
NY
251F00000X
Home Infusion Agency
9589L001
NY
251J00000X
Nursing Care Agency
9589L001
NY
Other
Enumeration date
04/26/2007
Last updated
10/06/2008
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