Organization
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Active
Organization
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Active
Other names
Roosevelt Community Health Center of Excellence
Organization subpart
No
Provider details
NPI number
Authorized official
LUCHY JACKSON (DIRECTOR OF MANAGED CARE)
(212) 238-7815
Entity
Organization
Contact information
Practice address
3750 72ND ST, JACKSON HEIGHTS, NY 11372-6143
(212) 238-7815
(212) 238-7629
Mailing address
3750 72ND ST, JACKSON HEIGHTS, NY 11372-6143
(466) 615-7800
(466) 615-7890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
04/02/2025
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