| Long Beach Reach Inc. | |
|
2-12 West Park Ave. Long Beach NY 11561 | |
| (516) 889-2332 | |
| (516) 889-2399 |
| Full Name | Long Beach Reach Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2-12 West Park Ave., Long Beach, New York |
| Authorized Official Name and Position | Joseph Smith (DIRECTOR) |
| Authorized Official Contact | 5168892332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Beach Reach Inc. 2-12 West Park Ave. Suite 200 Long Beach NY 11561 Ph: (516) 889-2332 | Long Beach Reach Inc. 2-12 West Park Ave. Long Beach NY 11561 Ph: (516) 889-2332 |
| NPI Number | 1285767608 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3779884572 |
|---|---|
| Medicare Enrollment ID | O20151221002106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285767608 | NPI | - | NPPES |
| 01764850 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New York) | Primary |
| Provider Name | Marianne E Brulhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952726564 PECOS PAC ID: 6305060757 Enrollment ID: I20140605000572 |
| Provider Name | Monica Suniti Pal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508294414 PECOS PAC ID: 1254557176 Enrollment ID: I20140729001257 |
| Provider Name | Margaret A. Oliver-smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508004797 PECOS PAC ID: 7517262843 Enrollment ID: I20160225000126 |
| Provider Name | Benjamin A Feld |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184007452 PECOS PAC ID: 0941505192 Enrollment ID: I20160225001141 |
| Provider Name | Kevin S Bragg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023271566 PECOS PAC ID: 8729385208 Enrollment ID: I20160329000104 |
| Provider Name | Frank G Bono |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912172131 PECOS PAC ID: 4082912852 Enrollment ID: I20160411001957 |
| Provider Name | Emily Frances Guarnotta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356798466 PECOS PAC ID: 9234422437 Enrollment ID: I20160726001772 |
| Provider Name | Thomas C Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013681113 PECOS PAC ID: 0941673552 Enrollment ID: I20230301002954 |
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