Provider Demographics
NPI:1427269141
Name:HANDS ACROSS LONG ISLAND, INC
Entity type:Organization
Organization Name:HANDS ACROSS LONG ISLAND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEALION
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:631-234-1925
Mailing Address - Street 1:159 BRIGHTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-2710
Mailing Address - Country:US
Mailing Address - Phone:631-234-1925
Mailing Address - Fax:631-234-7258
Practice Address - Street 1:159 BRIGHTSIDE AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-2710
Practice Address - Country:US
Practice Address - Phone:631-234-1925
Practice Address - Fax:631-234-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8684006A251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02871850Medicaid
NYNYBN12794Medicare PIN