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Organization

NYCDOHMH HILLSIDE AVENUE HEALTH CENTER

Active
Other names
New York City Department of Health and Mental Hygiene Hillside Avenue
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL JAMES SMOOK MPA (ADMINISTRATIVE MANAGER THIRD PARTY)
(212) 442-8468
Entity
Organization

Contact information

Practice address
164 21 HILLSIDE AVENUE, NYCDOHMH HILLSIDE AVENUE HEALTH CENTER, JAMAICA, NY 11432-4140
(718) 676-2259
(718) 262-8885
Mailing address
PO BOX 74, 125 WORTH STREET RM 901, NEW YORK, NY 10013-4006
(212) 442-8468
(212) 442-8452

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
7002112R5621
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00247549
NY
Enumeration date
05/26/2006
Last updated
08/22/2020
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