Provider Demographics
NPI:1902482201
Name:DA VINCI EDUCATION & RESEARCH
Entity Type:Organization
Organization Name:DA VINCI EDUCATION & RESEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF BEHAVIORAL HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-928-4815
Mailing Address - Street 1:550 N COUNTRY RD STE F
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-1429
Mailing Address - Country:US
Mailing Address - Phone:631-928-4815
Mailing Address - Fax:631-928-4817
Practice Address - Street 1:550 N COUNTRY RD STE F
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1429
Practice Address - Country:US
Practice Address - Phone:631-928-4815
Practice Address - Fax:631-928-4817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health