Organization
PEDERSON KRAG CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN ROTHMAN LMSW (FAMILY SPECIALIST)
(631) 920-8351
Entity
Organization
Contact information
Practice address
11 ROUTE 111, SMITHTOWN, NY 11787-3712
(631) 920-8300
Mailing address
11 ROUTE 111, SMITHTOWN, NY 11787-3712
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
072099
NY
Other
Enumeration date
03/10/2011
Last updated
03/10/2011
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