Organization
SHELTER ROCK PSYCHIATRIC SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK NASS M.D. (PRESIDENT)
(631) 321-7697
Entity
Organization
Contact information
Practice address
580 SUNRISE HWY, WEST BABYLON, NY 11704-6000
(631) 321-7697
(631) 321-6140
Mailing address
580 SUNRISE HWY, WEST BABYLON, NY 11704-6000
(631) 321-7697
(631) 321-6140
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
128697
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128697
NYS LICENSE NUMBER
NY
Enumeration date
08/09/2010
Last updated
08/09/2010
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