Organization
SUFFOLK COUNTY DEPT OF HEALTH SERVICES
Active
Other names
BOCES - School Based Program
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GRAHAM M.D., M.P.H. (ACTING COMMISSIONER)
(631) 853-3000
Entity
Organization
Contact information
Practice address
350 MARTHA AVENUE, BELLPORT, NY 11713
(631) 854-1200
Mailing address
225 RABRO DR EAST, HAUPPAUGE, NY 11788
(631) 853-4026
(631) 853-2922
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
5155200R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473170
—
NY
Enumeration date
11/24/2006
Last updated
08/22/2020
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