1306898432 NPI number — COMMUNITY HEALTH PROJECT INC.

Table of content: (NPI 1306898432)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306898432 NPI number — COMMUNITY HEALTH PROJECT INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH PROJECT 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:
CALLEN-LORDE COMMUNITY HEALTH CENTER
Provider Other Organization Name Type Code:
3
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:
1306898432
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
356 W 18TH ST
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:
10011-4401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-271-7280
Provider Business Mailing Address Fax Number:
212-271-8111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
356 W 18TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10011-4401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-271-7280
Provider Business Practice Location Address Fax Number:
212-271-8111
Provider Enumeration Date:
05/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARTIN
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
COMPLIANCE ANALYST
Authorized Official Telephone Number:
212-271-7269

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , 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: 01854282 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".