Organization
PROJECT RENEWAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN GIFTOS MD (MEDICAL DIRECTOR)
(212) 533-8400
Entity
Organization
Contact information
Practice address
8 E 3RD ST FL 2, NEW YORK, NY 10003-8908
(212) 533-8400
Mailing address
PO BOX 1469, BRONX, NY 10451-1469
(646) 544-8855
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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