1073549192 NPI number — IHS OF NEW YORK INC

Table of content: JULI CHRISTINE MEYER MSSW,LICSW (NPI 1447275532)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073549192 NPI number — IHS OF NEW YORK INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IHS OF NEW YORK 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:
6
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:
1073549192
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6001 BROKEN SOUND PKWY
Provider Second Line Business Mailing Address:
SUITE 508
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33487-2765
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-443-0743
Provider Business Mailing Address Fax Number:
561-443-7296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 PELHAM PKWY S
Provider Second Line Business Practice Location Address:
JACOBI MEDICAL CENTER BLDG 5 A1
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10461-1138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-409-1909
Provider Business Practice Location Address Fax Number:
718-409-1823
Provider Enumeration Date:
06/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCDONNELL
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-361-1113

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 03009161 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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