OrganizationActive
Constractor
NPI 1184025058 · Exclusive Provider Organization · Valley Stream, NY
Provider details
- NPI number
- 1184025058
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Guerline Gomez, Special Education Teacher(347) 962-2006
- License
- 824950 (NY)
Specialties & taxonomies
Managed Care Organizations
Practice location
3 Georgia St
Valley Stream, NY 11580-2224
Phone: (347) 962-2006
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 82
Valley Stream, NY 11582-0082
Registry dates
- Enumerated
- 2014-09-10
- Last updated
- 2014-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.