Provider Demographics
NPI:1740629062
Name:TAKE CONTROL OF YOUR HEALTH INC.
Entity type:Organization
Organization Name:TAKE CONTROL OF YOUR HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER VASCULAR SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:KRONEMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:RVS
Authorized Official - Phone:631-463-3747
Mailing Address - Street 1:1416 ACKERSON BLVD
Mailing Address - Street 2:PO BOX 1248
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-3845
Mailing Address - Country:US
Mailing Address - Phone:631-463-3747
Mailing Address - Fax:631-968-2401
Practice Address - Street 1:1416 ACKERSON BLVD
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-3845
Practice Address - Country:US
Practice Address - Phone:631-463-3747
Practice Address - Fax:631-968-2401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00081464305S00000X
335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier