Organization
EZRAS CHOILIM HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL MITTELMAN (EXECUTIVE DIRECTOR)
(845) 782-3242
Entity
Organization
Contact information
Practice address
49 FOREST RD FL 3, MONROE, NY 10950-2923
(845) 782-3242
Mailing address
49 FOREST RD FL 3, MONROE, NY 10950-2923
(845) 782-3242
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01620680
—
NY
Enumeration date
04/02/2019
Last updated
04/02/2019
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