Organization
NYCDOHMH-BOARD OF ED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN ELLIOT CARTER (DIRECTOR, MEDICAID & MEDICARE REVEN)
(212) 232-2423
Entity
Organization
Contact information
Practice address
2 LAFAYETTE ST, 22ND FLOOR, NEW YORK, NY 10007-1307
(212) 676-2474
Mailing address
42 BROADWAY, SUITE 1611, NEW YORK, NY 10004-1617
(212) 232-2421
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
01647043
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01647043
—
NY
Enumeration date
10/14/2009
Last updated
10/14/2009
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