Organization
SAMARITAN DAYTOP VILLAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES MADRAY (VP OF HEALTH SERVICES & COMM BASED)
(718) 206-2000
Entity
Organization
Contact information
Practice address
368 E 148TH ST, BRONX, NY 10455-4005
(718) 402-2614
(718) 402-5017
Mailing address
138-02 QUEENS BLVD, BRIARWOOD, NY 11435
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
132690403
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012222191
—
NY
Enumeration date
06/11/2006
Last updated
04/14/2016
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