1336419217 NPI number — LINCOLN MEDICAL AND MENTAL HEALTH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336419217 NPI number — LINCOLN MEDICAL AND MENTAL HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINCOLN MEDICAL AND MENTAL HEALTH
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:
1336419217
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
620 LENOX AVE
Provider Second Line Business Mailing Address:
APPT NO 7S
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10037-1204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
862-812-3992
Provider Business Mailing Address Fax Number:
718-579-4836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
234 E 149TH ST
Provider Second Line Business Practice Location Address:
LINCOLN MEDICAL AND MENTAL HEALTH CENTER
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10451-5504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-579-5874
Provider Business Practice Location Address Fax Number:
718-579-4836
Provider Enumeration Date:
01/09/2012

Additional Information

Authorized Official

Authorized Official Last Name:
GARG
Authorized Official First Name:
NEHA
Authorized Official Middle Name:
Authorized Official Title or Position:
RESIDENT
Authorized Official Telephone Number:
862-812-3992

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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