Organization
LINCOLN MEDICAL & MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDELMIRO GONZALEZ LCSW-R (SOCIAL WORK SUPERVISOR II)
(718) 579-5657
Entity
Organization
Contact information
Practice address
4510 KISSENA BLVD, FLUSHING, NY 11355-3431
(718) 661-2636
Mailing address
4510 KISSENA BLVD, FLUSHING, NY 11355-3431
(718) 661-2636
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O349041
SOCIAL WORK
NY
Enumeration date
01/17/2007
Last updated
08/22/2020
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