| Bethpage Adolescent Development Association Inc | |
|
936 Stewart Ave Bethpage NY 11714 | |
| (516) 433-5344 | |
| (516) 433-5067 |
| Full Name | Bethpage Adolescent Development Association Inc |
|---|---|
| Speciality | Social Worker |
| Location | 936 Stewart Ave, Bethpage, New York |
| Authorized Official Name and Position | Fred Lippman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5164335344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethpage Adolescent Development Association Inc 936 Stewart Ave Bethpage NY 11714 Ph: (516) 433-5344 | Bethpage Adolescent Development Association Inc 936 Stewart Ave Bethpage NY 11714 Ph: (516) 433-5344 |
| NPI Number | 1316143951 |
|---|---|
| Provider Enumeration Date | 06/21/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316143951 | NPI | - | NPPES |
| 2452459 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | OASASCO70611506 (New York) | Primary |
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