Provider Demographics
NPI:1336723261
Name:VICTIMS INFORMATION BUREAU OF SUFFOLK
Entity Type:Organization
Organization Name:VICTIMS INFORMATION BUREAU OF SUFFOLK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PARROTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:631-360-3930
Mailing Address - Street 1:185 OVAL DR
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1402
Mailing Address - Country:US
Mailing Address - Phone:631-360-3730
Mailing Address - Fax:
Practice Address - Street 1:185 OVAL DR
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1402
Practice Address - Country:US
Practice Address - Phone:631-360-3730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)