Provider Demographics
NPI:1336531128
Name:BROOKHAVEN SCIENCE ASSOCIATES
Entity Type:Organization
Organization Name:BROOKHAVEN SCIENCE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, OCCUPATIONAL MEDICINE CLIN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:FALCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-344-3666
Mailing Address - Street 1:30 BELL AVE.
Mailing Address - Street 2:BLDG 490 OMC
Mailing Address - City:UPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11973-5000
Mailing Address - Country:US
Mailing Address - Phone:631-344-3666
Mailing Address - Fax:631-344-7366
Practice Address - Street 1:30 BELL AVE
Practice Address - Street 2:BLDG 490
Practice Address - City:UPTON
Practice Address - State:NY
Practice Address - Zip Code:11973-5000
Practice Address - Country:US
Practice Address - Phone:631-344-3666
Practice Address - Fax:631-344-7366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192014-1261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine