Provider Demographics
NPI:1205298551
Name:PSB
Entity type:Organization
Organization Name:PSB
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:516-308-4840
Mailing Address - Street 1:1035 PARK BLVD
Mailing Address - Street 2:2C
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-2743
Mailing Address - Country:US
Mailing Address - Phone:516-308-4840
Mailing Address - Fax:516-809-9338
Practice Address - Street 1:1035 PARK BLVD
Practice Address - Street 2:2C
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-2743
Practice Address - Country:US
Practice Address - Phone:516-308-4840
Practice Address - Fax:516-809-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1186L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health