Organization
ADULT CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON LEIDER M.D. (CLINIC DIRECTOR)
(718) 918-3669
Entity
Organization
Contact information
Practice address
1400 PELHAM PKWY S, 6 A CLINIC, BUILDING 5, 6TH FLOOR, BRONX, NY 10461-1138
(718) 918-4331
(718) 918-7686
Mailing address
1400 PELHAM PKWY S, 6 A CLINIC, BUILDING 5, 6TH FLOOR, BRONX, NY 10461-1138
(718) 918-4331
(718) 918-7686
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0801X
NY
Other
Enumeration date
09/14/2007
Last updated
09/14/2007
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