1023122181 NPI number — PUERTO RICAN FAMILY INSTITUTE, INC.

Table of content: (NPI 1023122181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023122181 NPI number — PUERTO RICAN FAMILY INSTITUTE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUERTO RICAN FAMILY INSTITUTE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023122181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
145 W 15TH ST FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10011-6701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-924-6320
Provider Business Mailing Address Fax Number:
212-691-5635

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9131 QUEENS BLVD STE 618
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELMHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11373-5543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-275-0983
Provider Business Practice Location Address Fax Number:
718-275-7973
Provider Enumeration Date:
08/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GIRONE
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
ELENA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
212-924-6320

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  6758110A , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00244880 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".