Organization
NYCDOHMH MOTTHYN CONNECT CMCM
Active
Other names
NYC Dept of Health & Mental Hygiene Mott Haven Connect CMCM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JAMES SMOOK MPA (ADMINISTRATIVE MGR 3D PARTY REVENUE)
(212) 442-5468
Entity
Organization
Contact information
Practice address
1309 FULTON AVENUE, NYCDOHMH MOTT HAVEN CONNECT CMCM, BRONX, NY 10456-2403
(718) 367-2450
(718) 367-5112
Mailing address
125 WORTH STREET, NYCDOHMH DIV OF DISEASE CONTROL RM 901 BOX 22, NEW YORK, NY 10004-4006
(212) 442-8468
(212) 442-8452
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
01234413026
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01234413
—
NY
Enumeration date
05/26/2006
Last updated
08/22/2020
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