Damian Family Care Centers, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

7003246R Issued in NY

Legal business name

DAMIAN FAMILY CARE CENTERS, INC.

Practice address

161 Lake Shore Rd
Lake Ronkonkoma, NY 11779-3182

Phone

(631) 306-5895

Fax

(718) 657-1870

NPI assigned

Feb 3, 2017

Organization subpart

Yes

Parent organization

DAMIAN FAMILY CARE CENTERS, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kavanaugh Chandler, MD

Title

President/ Ceo

Phone

(718) 657-1100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Project Samaritan Health Services Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 571115

Legal name

DAMIAN FAMILY HEALTH CARE INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 19, 2018

Last certification

Jun 19, 2018

Ownership / control type

For profit – corporation

Facility address

161 Lake Shore Road
Lake Ronkonkoma, NY 11779

Part of

Damian Family Care Ctr

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1265970834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8956 162ND ST FL 3",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325072",
            "telephone_number": "718-657-1100",
            "fax_number": "718-657-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 LAKE SHORE RD",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117793182",
            "telephone_number": "631-306-5895",
            "fax_number": "718-657-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMIAN FAMILY CARE CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAMIAN FAMILY CARE CENTERS, INC.",
        "enumeration_date": "2017-02-03",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "KAVANAUGH",
        "authorized_official_title_or_position": "PRESIDENT/ CEO",
        "authorized_official_telephone_number": "718-657-1100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "7003246R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05260760",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Project Samaritan Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Project Samaritan Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Marie Corideo
• Alexis Nicole Corsino
• Megan Melissa Crain, LPN
• Carmen Michela Crocitto
• Lesley Cunningham, RN
• Lindsay Blair Daniels, LMSW
• Daniella Davis
• Dawnmarie Maloney L.C.S.W., PLLC
• Haley Jane Dennerlein, PT, DPT
• Stephen George Donohue, R.N.

• Federally Qualified Health Center (FQHC) in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Federally Qualified Health Center (FQHC) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.