CS Medical Associates, P.C.
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Massapequa Park, NY
NPI 1619642006 · NPPES record last updated Aug 9, 2021
Key facts
- NPI
- 1619642006
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- Legal business name
- CS MEDICAL ASSOCIATES, P.C.
- Practice address
- 5100 Sunrise Hwy FL 2
Massapequa Park, NY 11762-2935 - Phone
- (631) 696-4357
- NPI assigned
- Aug 9, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- CS MEDICAL ASSOCIATES, P.C.
Authorized official
- Name
- Tracey Wallace
- Title
- VP Operations
- Phone
- (631) 696-4357
Corporate family (same tax ID) 7
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2232843 | CS Medical Associates PC | Certificate of waiver | Mar 26, 2027 |
| 33D2337017 | CS Medical Associates PC | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
- Tax ID family
- CS Medical Associates PC
- Part of
- CS Medical Associates PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Clinical Social Worker |
1041C0700X | |||
| Addiction Medicine (Preventive Medicine) Physician |
2083A0300X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Yes |
Addresses
Primary practice location
5100 Sunrise Hwy FL 2
Massapequa Park, NY 11762-2935
Mailing address
100 Granny Rd Ste 1
Farmingville, NY 11738-2879
Phone (631) 696-4357
Other names
- Victory Recovery Partners
Other providers in Massapequa Park, NY
- Jill Susan Costa
- Richard Joseph Cowan
- Lauren Crespo
- Theresa Ann Cretella
- Joseph Michael Cristoforo
- Patricia A Cummings
- Margaret Mary Curley
- Mary Cutrone-Foley
- Joseph Paul Dabovich II
- Petrina Daleo
All providers in Massapequa Park, NY · Substance Use Disorder Rehabilitation Clinic/Center in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.