CS MEDICAL ASSOCIATES, P.C. (NPI# 1346880960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346880960 |
| Entity Type | Organization |
| Organization Name | CS MEDICAL ASSOCIATES, P.C. |
| Practice Address |
2 Coraci Blvd Ste 15 Shirley NY 11967-4833 |
| Mailing Address |
100 Granny Rd Ste 1 Farmingville NY 11738-2879 |
| Practice Telephone | 6316964357 |
| Practice Fax Number | 6318468138 |
| Mailing Telephone | 6316964357 |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2020-01-11 |
| Authorized Official Name | TRACEY WALLACE (VP OPS) |
| Authorized Official Telephone | 6316964357 |
| Is Organization Subpart | Y |
| Parent Organization Name | CS MEDICAL ASSOCIATES, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 2083A0300X | ||||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Victory Recovery Partners | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548820608 | Cs Medical Associates, P.C. | Family Medicine | 727 N Broadway Ste B1, Massapequa, NY 11758-2348 | 2019-06-19 |
| 1043873417 | Cs Medical Associates, P.C. | 1228 E Main St Ste A, Riverhead, NY 11901-2677 | 2019-04-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CS MEDICAL ASSOCIATES, P.C. | 100 Granny Rd Ste 1, Farmingville, NY 11738-2879 |
| New York State Corporations | CS MEDICAL ASSOCIATES, P.C. | 192 Lexington Ave 17th Floor, Attn: Joseph T. Pareres, New York, Ny 10016 |
| Street Address |
2 CORACI BLVD STE 15 |
| City | SHIRLEY |
| State | NY |
| Zip Code | 11967-4833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588149744 | Dawn Kirby | Licensed Practical Nurse | 8 Crestwood Drive, Shirley, NY 11967 | 2018-10-03 |
| 1538684451 | Crystal E Gambles | Licensed Practical Nurse | 502 Wellwood Drive, Shirley, NY 11967 | 2017-08-11 |
| 1003330887 | Aura Blum Care, Inc | Licensed Practical Nurse | 436 Auborn Av, Shirley, NY 11967 | 2017-08-02 |
| 1891239687 | Holly Scott-rodriguez | Behavior Technician | 57 Probst Drive, Shirley, NY 11967 | 2016-12-13 |
| 1487106357 | Joann C Duran | Licensed Practical Nurse | 320 Decatur Avenue, East Yaphank, NY 11967 | 2016-10-26 |
| 1053776815 | Andrea Janet Murphy-hamilton | Registered Nurse | 369 Puritan Dr., N Shirley, NY 11967 | 2015-12-22 |
| 1588039598 | Thomas B Maher | Student in an Organized Health Care Education/Training Program | 483 West End Ave., Shirley, NY 11967 | 2015-12-02 |
| 1346676707 | Sharon Marie Dougherty | Social Worker | 1250 William Floyd Parkway, Shirley, NY 11967 | 2013-09-17 |
| 1083964241 | Charlotte Dametra Fleming | Licensed Practical Nurse | 420 Lakepointe Drive, Middleisland, NY 11967 | 2012-09-14 |
| 1982954277 | Sefika Dimaggio | Registered Nurse | 32 Candido Ave, Shirley, NY 11967 | 2012-09-13 |
| Find all providers in zip 11967 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1972013084 | Professional Counseling Services, Inc | Clinic/Center | 5700 W Genesee St Ste 118, Camillus, NY 13031-3217 | 2017-10-03 |
| 1760831119 | Vasuli Inc | Clinic/Center | 325 W 45th St, 812, New York, NY 10036-4191 | 2016-06-07 |
| 1093187254 | Samaritan Daytop Village, Inc. | Clinic/Center | 2778 Third Avenue, Bronx, NY 10455 | 2015-10-28 |
| 1588066716 | Care Counseling Center, LLC | Clinic/Center | 214 W 116th St, New York, NY 10026-2494 | 2014-09-18 |
| 1831507573 | Nathaniel Chambers | Clinic/Center | 801 Saint Anns Ave, Bronx, NY 10456-7648 | 2014-07-25 |
| 1508272238 | Trinity of Chemung County | Clinic/Center | 150 Lake St Ste 2, Elmira, NY 14901-3401 | 2014-07-02 |
| 1093074825 | Community Counseling & Mediation | Clinic/Center | 367 E 7th St, Brooklyn, NY 11218-4105 | 2012-05-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.