Provider Demographics
NPI:1093836470
Name:CANCER SUPPORT TEAM
Entity Type:Organization
Organization Name:CANCER SUPPORT TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBROF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-777-2777
Mailing Address - Street 1:875 MAMARONECK AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1900
Mailing Address - Country:US
Mailing Address - Phone:914-777-2777
Mailing Address - Fax:914-777-2780
Practice Address - Street 1:875 MAMARONECK AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1900
Practice Address - Country:US
Practice Address - Phone:914-777-2777
Practice Address - Fax:914-777-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9260L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health