# 25 CHAPEL STREET

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548623424
- **Authorized official:** LORIN BLAKE (CLINICAL DIRECTOR)
- **Authorized official phone:** (718) 398-0153

## Contact information

- **Practice address:** 25 CHAPEL ST, SUITE 901, BROOKLYN, NY 11201-1952
- **Practice address phone:** (718) 398-0153
- **Mailing address:** 301 W 130TH ST, APT 3C, NEW YORK, NY 10027-1813
- **Mailing address phone:** (646) 542-3980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 094063 | NY | Yes |

## Other

- **Enumeration date:** 03/30/2016
- **Last updated:** 03/30/2016