Organization
USCG SECTOR NEW YORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L. ARMENTROUT (CLINIC ADMINISTRATOR)
(718) 354-4341
Entity
Organization
Contact information
Practice address
215 DRUM ROAD, ROOM D-113, STATEN ISLAND, NY 10305
(718) 354-4414
(718) 354-4415
Mailing address
215 DRUM ROAD, ROOM D-113, STATEN ISLAND, NY 10305
(718) 354-4414
(718) 354-4415
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
0101050128
VA
Other
Enumeration date
01/24/2006
Last updated
09/24/2010
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