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PROVIDENT HEALTH PARTNERS INC.
NPI 1275157000
Clinic/Center in Medford, NY

Active since June 08, 2020
1529 N OCEAN AVE STE A, MEDFORD, NY 11763(631) 266-4501(631) 266-4502 Get Directions Write a Review

NPPES record last updated: June 8, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Provident Health Partners Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENT HEALTH PARTNERS INC. (NPI 1275157000) is a healthcare organization registered as a clinic/center in Medford, New York and active in the NPI registry since June 2020. The organization lists Jennifer Desousa, Administrator, as its authorized official.

NPPES Registry Identity

NPI1275157000
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePROVIDENT HEALTH PARTNERS INC.
Location Address1529 N OCEAN AVE STE AMedford, NY 11763-3587
Mailing Address554 Larkfield Rd Ste 207East Northport, NY 11731-4205 · (631) 266-4501 · Fax (631) 266-4502
Phone(631) 266-4501
Fax(631) 266-4502
Organization SubpartNo
Authorized OfficialJennifer DesousaAdministrator · (631) 266-4501
Enumeration DateJune 8, 2020
NPPES CertifiedJune 8, 2020
✔ NPI 1275157000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1529 N OCEAN AVE STE A, Medford, NY 11763
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provident Health Partners Inc.'s NPI number?

The NPI number for Provident Health Partners Inc. is 1275157000. It was assigned to this organization in the NPPES registry on June 8, 2020.

Where is Provident Health Partners Inc. located?

Provident Health Partners Inc. is located at 1529 N Ocean Ave Ste A, Medford, NY 11763. The listed phone number is (631) 266-4501.

What is Provident Health Partners Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Provident Health Partners Inc. was last updated on June 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.