Organization
COUNTY OF SUFFOLK
Active
Other names
Brentwood Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES L. TOMARKEN MSW,MPH,MBA,FRCPC,FA (COMMISSIONER)
(631) 854-0100
Entity
Organization
Contact information
Practice address
1869 BRENTWOOD RD, BRENTWOOD, NY 11717-4625
(631) 853-3400
(631) 853-3493
Mailing address
3500 SUNRISE HWY, SUITE 124, P.O. BOX 9006, GREAT RIVER, NY 11739-9006
(631) 854-0000
(631) 854-0108
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
5155200R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03003707
—
NY
Enumeration date
07/03/2006
Last updated
10/25/2012
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