Organization
PGCMH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RONIT SHEMI LCSW (PROGRAM DIRECTOR)
(212) 560-6700
Entity
Organization
Contact information
Practice address
1775 GRAND CONCOURSE 8TH FL, NY, NY 10457
(212) 560-6700
Mailing address
1775 GRAND CONCOURSE 8TH FL, NY, NY 10457
(212) 560-6700
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244257
—
NY
Enumeration date
11/30/2018
Last updated
06/11/2019
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