1700300456 NPI number — FOCUS MENTAL HEALTH SOLUTIONS OF LONG ISLAND, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700300456 NPI number — FOCUS MENTAL HEALTH SOLUTIONS OF LONG ISLAND, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOCUS MENTAL HEALTH SOLUTIONS OF LONG ISLAND, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700300456
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 BROADHOLLOW RD STE 310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MELVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11747-4987
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-906-4970
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 BROADHOLLOW RD STE 310
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MELVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11747-4987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-906-4970
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/02/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SCHOENBACH
Authorized Official First Name:
STACY
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHIATRIC NURSE PRACTITIONER
Authorized Official Telephone Number:
631-707-2394

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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