DAMIAN FAMILY CARE CENTER, INC. (NPI# 1265970834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265970834 |
| Entity Type | Organization |
| Organization Name | DAMIAN FAMILY CARE CENTER, INC. |
| Other Organization Name | PROJECT SAMARITAN HEALTH SERVICES |
| Practice Address |
161 Lake Shore Rd Lake Ronkonkoma NY 11779-3182 |
| Mailing Address |
13802 Queens Blvd Briarwood NY 11435-2642 |
| Practice Telephone | 6313065895 |
| Practice Fax Number | 7186571870 |
| Mailing Telephone | 7186571100 |
| Mailing Fax Number | 7186571870 |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |
| Authorized Official Name | MR. PETER GRISAFI (PRESIDENT/ CEO) |
| Authorized Official Telephone | 7186571100 |
| Is Organization Subpart | Y |
| Parent Organization Name | DAMIAN FAMILY CARE CENTERS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
7003246R | NY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Project Samaritan Health Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650688 | Damian Family Care Center, Inc. | Clinic/Center | 13 Hell Gate Cir, New York, NY 10035-6602 | 2017-10-13 |
| 1104915123 | Damian Family Care Center, Inc. | Clinic/Center | 225 E 53rd St, New York, NY 10022 | 2006-10-11 |
| 1619415288 | Damian Family Care Center, Inc. | Clinic/Center | 3411 Vernon Blvd, Long Island City, NY 11106-5121 | 2017-02-03 |
| 1154868594 | Damian Family Care Center, Inc. | Clinic/Center | 11711 Myrtle Ave, Richmond Hill, NY 11418-1751 | 2017-01-24 |
| Street Address |
161 LAKE SHORE RD |
| City | LAKE RONKONKOMA |
| State | NY |
| Zip Code | 11779-3182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831613868 | Theresa Bergold | Counselor | 161 Lake Shore Rd, Lake Ronkonkoma, NY 11779-3182 | 2017-08-01 |
| 1134640980 | Saturne Phillip | Social Worker | 161 Lake Shore Rd, Lake Ronkonkoma, NY 11779-3182 | 2017-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | LAKE RONKONKOMA |
| Zip Code | 11779 |
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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.