Dept. of Health

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

376106-1 Issued in NY

Legal business name

DEPT. OF HEALTH

Practice address

200 Wireless Blvd
Hauppauge, NY 11788-3933

Phone

(631) 853-7373

Fax

(631) 853-7380

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Patrick Martone

Title

Registered Nurse

Phone

(631) 853-7373

Specialties & licenses 1

Addresses

Other names 1

• suffolk county Other name

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1659491975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 CHERRY LN",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634022",
            "telephone_number": "631-447-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WIRELESS BLVD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883933",
            "telephone_number": "631-853-7373",
            "fax_number": "631-853-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPT. OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "MARTONE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "631-853-7373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NY",
            "license": "376106-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "suffolk county",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tara Rose Delurey
• Rick Alan Delzell
• Marjorie S. Demshock, LMHC
• Dennis Mihale MD of Ny PC
• Kathleen Mary Depalo-Mooney
• Daniella Derby, MSW
• Nicole B Derosa
• Donna Marie Derose, RN
• Chamka Destina
• Destination Dental PLLC

• Methadone Clinic in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Methadone Clinic in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.