| NAME |
PATCHOGUE |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
4 PHYLLIS DRIVE |
| CITY |
PATCHOGUE |
| ZIP |
11772-2900 |
| OFFICIAL VA NAME |
Patchogue,NY ORC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PATCHOGUE VA CBOC |
| ST. ADDR. 1 (MAILING) |
4 PHYLLIS DRIVE |
| CITY (MAILING) |
PATCHOGUE |
| STATE (MAILING) |
NEW YORK |
| ZIP (MAILING) |
11772-2900 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1700820438
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
632HD |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1700820438
-
- CODING SYSTEM: VASTANUM
- ID: 632HD
|
