# NYCDOHMH MOTTHYN CONNECT CMCM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NYC Dept of Health & Mental Hygiene Mott Haven Connect CMCM
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104872506
- **Authorized official:** MR. MICHAEL JAMES SMOOK MPA (ADMINISTRATIVE MGR 3D PARTY REVENUE)
- **Authorized official phone:** (212) 442-5468

## Contact information

- **Practice address:** 1309 FULTON AVENUE, NYCDOHMH MOTT HAVEN CONNECT CMCM, BRONX, NY 10456-2403
- **Practice address phone:** (718) 367-2450
- **Practice address fax:** (718) 367-5112
- **Mailing address:** 125 WORTH STREET, NYCDOHMH DIV OF DISEASE CONTROL RM 901 BOX 22, NEW YORK, NY 10004-4006
- **Mailing address phone:** (212) 442-8468
- **Mailing address fax:** (212) 442-8452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 01234413026 | NY | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 08/22/2020