Organization
URBAN HEALTH PLAN, INC.
Active
Parent organization
SENECA HOUSE - PART TIME CLINIC
Other names
SENECA HOUSE - Part Time Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
SENECA HOUSE - PART TIME CLINIC
Authorized official
DR. SAMUEL DELEON JR. MD (VP/CMO MEDICAL AFFAIRS)
(718) 589-2440
Entity
Organization
Contact information
Practice address
1215 SENECA AVE, BRONX, NY 10474-4620
(718) 589-2440
(718) 991-4516
Mailing address
1215 SENECA AVE, BRONX, NY 10474-4620
(718) 589-2440
(718) 991-4516
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02994952
—
NY
Enumeration date
03/10/2011
Last updated
03/10/2011
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