Vidal, Jake

Vidal, Jake is an individual health care provider with primary practice located at 225 Broadhollow Rd Ste 402 , Melville NY 11747-4899. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Vidal, Jake can be contacted via phone (631) 385-7780.

Contact Information

Primary practice address
225 Broadhollow Rd Ste 402 Melville NY 11747-4899
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X

Profile Details

NPI number 1932839271
LBN Legal business name Vidal, Jake
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2022
Last updated Jun 10th, 2022 - about 2 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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