1962593210 NPI number — YESHIVA UNIVERSITY

Table of content: (NPI 1962593210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962593210 NPI number — YESHIVA UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YESHIVA UNIVERSITY
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:
SOUND VIEW THROGS NECK COMMUNITY MENTAL HEALTH CENTER
Provider Other Organization Name Type Code:
5
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:
1962593210
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1300 MORRIS PARK AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-904-4420
Provider Business Mailing Address Fax Number:
718-931-7307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2527 GLEBE AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-904-4420
Provider Business Practice Location Address Fax Number:
718-931-7307
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GENN
Authorized Official First Name:
EMANUEL
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSOCIATE DEAN FOR BUSINESS AFFAIRS
Authorized Official Telephone Number:
718-430-3182

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 041210000000 . This is a "FIDELIS ID#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3106231 . This is a "GHI PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00759944 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04121000000 . This is a "CENTER CARE ID #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1037430 . This is a "BEACON PROV #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 142975 . This is a "VALUEOPTIONS PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 251311 . This is a "COMP PSYCH ID #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 118353 . This is a "HARMONY PROVIDER #" identifier . This identifiers is of the category "OTHER".




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