Madonna Heights Family SVC CL

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MADONNA HEIGHTS FAMILY SVC CL

Practice address

1 Alexander PL
Glen Cove, NY 11542-3745

Phone

(516) 759-1844

NPI assigned

Dec 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert J McMahon

Title

Executive Director

Phone

(516) 759-1844

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sco Family of Srevice Doing business as

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1891979134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ALEXANDER PLACE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "11542",
            "telephone_number": "516-759-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ALEXANDER PL",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423745",
            "telephone_number": "516-759-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADONNA HEIGHTS FAMILY SVC CL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "516-759-1844",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00675530",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sco Family of Srevice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bonnie Lynch, R.N.
• Maria Lyons-Pellechia, NP
• M.Y. Wellness & Rehab Studio
• Erin Macbride
• Gregory Scott Mack
• Renee Maggiore, LMHC
• David C Mainenti, L. AC., DIPL. O.M.
• Justin Gene Maiorana
• Pulkit Malik, M.D.
• Urooj Kusar Malik, PHARMD

• Community/Behavioral Health Agency in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Community/Behavioral Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; 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.