Organization
MISSION OF THE IMMACULATE VIRGIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN W RYNN (EXECUTIVE DIRECTOR)
(718) 317-2803
Entity
Organization
Contact information
Practice address
6581 HYLAN BLVD, STATEN ISLAND, NY 10309-3830
(718) 317-2803
(718) 317-2830
Mailing address
6581 HYLAN BLVD, STATEN ISLAND, NY 10309-3830
(718) 317-2803
(718) 317-2830
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
7943436
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02002633
—
NY
Enumeration date
11/02/2007
Last updated
07/31/2008
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