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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