Lucien, Jean Gardy M

Lucien, Jean Gardy M is an individual health care provider with primary practice located at 320 Carleton Ave , Central Islip NY 11722-4506. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Lucien, Jean Gardy M can be contacted via phone (631) 663-4300.

Contact Information

Primary practice address
320 Carleton Ave Central Islip NY 11722-4506
Phone: (631) 663-4300
Fax: (631) 439-4066
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1518441716
LBN Legal business name Lucien, Jean Gardy M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2018
Last updated Sep 24th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518441716 NPPES
New York MEDICAID 1964
New York MEDICAID 1975

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