Organization
PROJECT RENEWAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCHELL NETBURN (PRESIDENT AND CEO)
(212) 620-0340
Entity
Organization
Contact information
Practice address
651 W 168TH ST, NEW YORK, NY 10032-3703
(212) 740-1780
Mailing address
200 VARICK ST, 9TH FLOOR, NEW YORK, NY 10014-4810
(212) 620-0340
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
7002161R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01921402
—
NY
Enumeration date
11/17/2016
Last updated
02/17/2022
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