NPIMap

Organization Active NPI

Ucpa of Suffolk Inc

  • Clinic/Center
  • Central Islip, NY
National Provider Identifier
1609964790
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
5157203R Issued in NY
Legal business name
UCPA OF SUFFOLK INC
Practice address
159 Carleton Ave
Central Islip, NY 11722-4172
Phone
(631) 439-4314
Fax
(631) 439-4319
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Authorized official

Name
Ms. Janine Klein
Title
Chief Financial Officer Ucpa
Phone
(631) 232-0011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 5157203R NY Primary

Addresses

Primary practice location

159 Carleton Ave
Central Islip, NY 11722-4172

Mailing address

250 Marcus Blvd
Hauppauge, NY 11788-2018
Phone (631) 439-4314

Other identifiers 1

IdentifierTypeStateIssuer
00354921MedicaidNY

Other names 1

  • UCP Suffolk Health Center Other name

National Provider Directory

National Provider Directory

Locations

159 Indian Head Rd
Commack, NY 11725
Phone (631) 543-4500

250 Marcus Blvd
Hauppauge, NY 11788
Phone (631) 439-4300

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1609964790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MARCUS BLVD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882018",
            "telephone_number": "631-439-4314",
            "fax_number": "631-439-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224172",
            "telephone_number": "631-439-4314",
            "fax_number": "631-439-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCPA OF SUFFOLK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "JANINE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER  UCPA",
        "authorized_official_telephone_number": "631-232-0011",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "5157203R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354921",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCP Suffolk Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Central Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.