Organization
COUNTY OF SUFFOLK
Active
Other names
ELSIE OWENS NO BROOKHAVEN HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES L TOMARKEN MSW,MPH,MBA,FRCPC,FA (COMMISSIONER)
(631) 854-0100
Entity
Organization
Contact information
Practice address
82 MIDDLE COUNTRY RD, CORAM, NY 11727-4411
(631) 854-2301
Mailing address
P.O. BOX 9006, 3500 SUNRISE HWY, SUITE 124, GREAT RIVER, NY 11739-9006
(631) 854-0000
(631) 854-0108
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03003734
—
NY
Enumeration date
09/08/2006
Last updated
10/25/2012
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