SUNRISE PARK PSYCHOTHERAPY LCSW PC; NPI #1376288530

Contact Information

SUNRISE PARK PSYCHOTHERAPY LCSW PC

1228 WANTAGH AVE STE 111
WANTAGH, NY 11793-2209

Phone: 516-644-6495
Fax: 516-324-3143
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Adult Mental Health	261QM0850X

Indicates primary specialty

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NPI Profile & details for SUNRISE PARK PSYCHOTHERAPY LCSW PC

NPI # 1376288530

LBN Legal business name SUNRISE PARK PSYCHOTHERAPY LCSW PC

Authorized official GINA CUBILLOS - (OWNER/PROVIDER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/02/2022

Last updated 05/02/2022 - More than a year ago

Identifiers

NY	Other	NKN592	BCBS ANTHEM ID
NY	Other	1048692	BEACON HEALTH OPTIONS

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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