Haven Medical Services, Plc

LBN: Haven Medical Services, Plc
Haven Medical Services, Plc is an health care organization with primary practice located at 1350 Route 112 , Port Jefferson Station NY 11776-3078. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Haven Medical Services, Plc can be contacted via phone (631) 473-3304, or through Go, Corazon M via phone (631) 473-3304.

Contact Information

Primary practice address
1350 Route 112 Port Jefferson Station NY 11776-3078
Phone: (631) 473-3304
Fax: (631) 474-1692
Website:
Map and Directions
Authorized official contact:
Name: Go, Corazon M Doctor of Medicine (MD)
Phone: (631) 473-3304

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 115112 New York

Profile Details

NPI number 1235301185
LBN Legal business name Haven Medical Services, Plc
DBA Doing business as
Authorized official Go, Corazon M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 1st, 2008
Last updated Apr 2nd, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235301185 NPPES
New York MEDICAID 00211463

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