Provider Demographics
NPI:1851774889
Name:EAC, INC
Entity Type:Organization
Organization Name:EAC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH SERVICES DIVISION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-539-0150
Mailing Address - Street 1:50 CLINTON ST
Mailing Address - Street 2:SUITE 107, EAC
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4281
Mailing Address - Country:US
Mailing Address - Phone:516-539-0150
Mailing Address - Fax:516-539-0160
Practice Address - Street 1:50 CLINTON ST
Practice Address - Street 2:SUITE 107, EAC
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4281
Practice Address - Country:US
Practice Address - Phone:516-539-0150
Practice Address - Fax:516-539-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1346302346OtherNPI
NY1538594049OtherNPI
NY02772503Medicaid