Organization
CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAUSHAL CHALLA MBA (CHIEF EXECUTIVE OFFICER)
(212) 379-6988
Entity
Organization
Contact information
Practice address
125 WALKER ST, NEW YORK, NY 10013-4135
(212) 226-8866
(212) 226-2289
Mailing address
268 CANAL ST, NEW YORK, NY 10013-3599
(212) 379-6988
(212) 379-6936
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
7002107R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00356318
—
NY
Enumeration date
08/04/2010
Last updated
09/29/2025
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