Provider Demographics
NPI:1881827905
Name:PROS R US
Entity Type:Organization
Organization Name:PROS R US
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:631-316-2942
Mailing Address - Street 1:P.O. BOX 202
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:631-316-2942
Mailing Address - Fax:
Practice Address - Street 1:2 LA BONNE VIE DR
Practice Address - Street 2:SUITE E
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4275
Practice Address - Country:US
Practice Address - Phone:631-316-2942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163W00000X
NY445607-01261QR0400X
NY445607-1313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty