Organization Name: | HOPE TMS MEDICAL PRACTICE PC |
NPI Number: | 1043562986 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RENA K FERGUSON (MEDICAL DIRECTOR) |
Mailing Address: | 646 Main St Suite 201 Port Jefferson |
State: | NY US |
Postal Code: | 117772235 |
Phone Number: | 6315096111 |
Fax Number: | 6315096112 |
NPI Enumeration Date: | 10/02/2012 |
NPI Last Update Date: | 10/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 230330 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |