Organization
COMMUNITY HEALTHCARE NETWORK, INC.
Active
Other names
Optometry Mobile
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN J. WENGROFSKY (VICE PRESIDENT OF FINANCE AND CFO)
(212) 545-2481
Entity
Organization
Contact information
Practice address
9704 SUTPHIN BLVD, JAMAICA, NY 11435-4721
(718) 657-7088
(718) 657-7092
Mailing address
60 MADISON AVE FL 5, NEW YORK, NY 10010-1600
(212) 545-2439
(646) 312-0481
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695941
—
NY
Enumeration date
11/29/2006
Last updated
01/16/2019
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