Organization
NYC DEPARTMENT OF HEALTH AND MENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET ELLIS (DIRECTOR OF PATIENT BILLING)
(347) 396-6299
Entity
Organization
Contact information
Practice address
42-09 28TH STREET, 17TH FLOOR, CN-48, LONG ISLAND CITY, NY 11101-4132
(646) 527-0267
(347) 396-3667
Mailing address
42-09 28TH STREET, 17TH FLOOR, CN-48, LONG ISLAND CITY, NY 11101-4132
(347) 396-6299
(347) 396-3667
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01426966
—
NY
Enumeration date
04/20/2007
Last updated
09/28/2023
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