NPI 1043330582

Mental Health

Organisation Point of Service Valley Stream, NY

Practice location

Address: 100 N Central Ave, Valley Stream, NY 11580-3821
Phone: (516) 593-5024
Fax: (516) 593-5026
Mailing address: 13316 143rd St, Jamaica, NY 11436-2111

Authorised official

Name: Olga J Mondesir
Title: Licensed Mental Health
Phone: (516) 593-5024

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 003165 (NY)

Other Point of Service providers in New York →

Registry record

NPI: 1043330582
Entity type: Organization
NPI issued: 29 Mar 2007
Record last updated: 16 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.