Organization
LONG ISLAND ADOLESCENT & FAMILY SERVICE,INC
Active
Organization
LONG ISLAND ADOLESCENT & FAMILY SERVICE,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE AQUINO (EXECUTIVE DIRECTOR)
(631) 444-4400
Entity
Organization
Contact information
Practice address
1413 STONY BROOK RD, STONY BROOK, NY 11790-2214
(631) 444-4400
Mailing address
1413 STONY BROOK RD, STONY BROOK, NY 11790-2214
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
CH00A09236
NY
261QH0100X
Health Service Clinic/Center
PJ00A09705
NY
261QH0100X
Health Service Clinic/Center
RH00A09372
NY
261QH0100X
Health Service Clinic/Center
Primary
SBH00A09585
NY
Other
Enumeration date
06/27/2007
Last updated
11/18/2014
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