ADVANTAGE CARE DIAGNOSTIC AND TREATMENT CENTER INC NPI 1073689600

NPI Information

NPI: 1073689600
Provider Name: ADVANTAGE CARE DIAGNOSTIC AND TREATMENT CENTER ,INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 33D1057847

Address:
189 WHEATLEY RD
BROOKVILLE, NY
ZIP 11545
Phone: (516) 626-1075
Get Directions

ADVANTAGE CARE DIAGNOSTIC AND TREATMENT CENTER ,INC is a federally qualified health center (fqhc) clinic center in Brookville, NY. ADVANTAGE CARE DIAGNOSTIC AND TREATMENT CENTER ,INC NPI is 1073689600. The provider is registered as an organization entity type.

The provider's business location address is:

189 WHEATLEY RD
BROOKVILLE, NY
ZIP 11545
Phone: (516) 626-1075
Fax: (516) 396-9766

The provider's authorized official is Rachele D Moise .
The authorized official title is Clinic Billing Manager and has the following contact phone number (516) 626-1075.

The CLIA number assigned to this NPI record is 33D1057847 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/27/2006 and was last updated on 8/21/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251K00000X	Public Health or Welfare				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02661801	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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