Provider Demographics
NPI:1720424419
Name:SUFFOLK COUNTY PERINATAL COALITION, INC
Entity Type:Organization
Organization Name:SUFFOLK COUNTY PERINATAL COALITION, INC
Other - Org Name:SUFFOLK PERINATAL COALITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-475-5400
Mailing Address - Street 1:475 E MAIN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3121
Mailing Address - Country:US
Mailing Address - Phone:631-475-5400
Mailing Address - Fax:631-475-5410
Practice Address - Street 1:475 E MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3121
Practice Address - Country:US
Practice Address - Phone:631-475-5400
Practice Address - Fax:631-475-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare