Organization
THE CHILD CENTER OF NY, INC.
Active
Other names
Queens Child Guidance Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEAN M COPPOLA (BILLING SYSTEM ADMINISTRATOR)
(718) 651-7770
Entity
Organization
Contact information
Practice address
11835 QUEENS BLVD, 6TH FLOOR, FOREST HILLS, NY 11375-7211
(718) 651-7770
(718) 396-8349
Mailing address
11835 QUEENS BLVD, 6TH FLOOR, FOREST HILLS, NY 11375-7211
(718) 651-7770
(718) 396-8349
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244371
—
NY
01
—
7403085
GHI
NY
01
—
WV0071
BLUE CROSS BLUE SHIELD
NY
Enumeration date
01/09/2007
Last updated
01/18/2017
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