Provider Demographics
NPI:1619261625
Name:PALLIATIVE CARE MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:PALLIATIVE CARE MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-224-6411
Mailing Address - Street 1:99 SUNNYSIDE BLVD
Mailing Address - Street 2:C/O HOSPICE CARE NETWORK
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2946
Mailing Address - Country:US
Mailing Address - Phone:516-832-7100
Mailing Address - Fax:516-224-6576
Practice Address - Street 1:99 SUNNYSIDE BLVD
Practice Address - Street 2:C/O HOSPICE CARE NETWORK
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2946
Practice Address - Country:US
Practice Address - Phone:516-832-7100
Practice Address - Fax:516-224-6576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186961174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty