Organization
LUTHERAN SOCIAL SERVICES OF NEW YORK
Active
Organization
LUTHERAN SOCIAL SERVICES OF NEW YORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SELENA SAMUELS (MEDICAL ASSURANCE COORDINATOR)
(212) 870-1171
Entity
Organization
Contact information
Practice address
475 RIVERSIDE DR, SUITE 1244, NEW YORK, NY 10115-0002
(212) 870-1171
(212) 870-1105
Mailing address
475 RIVERSIDE DRIVE, SUITE 1244, NEW YORK CITY, NY 10115-0037
(212) 870-1171
(212) 870-1105
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00343408
MEDICAID PROVIDER
NY
Enumeration date
08/30/2007
Last updated
08/30/2007
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