Organization
DEPARTMENT OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PONZELLA O JOHNSON R.N. (STAFF NURSE)
(212) 864-2400
Entity
Organization
Contact information
Practice address
370 W 118TH ST, SUITE 2B, NEW YORK, NY 10026-1015
(212) 864-2400
Mailing address
370 W 118TH ST, SUITE 2B, NEW YORK, NY 10026-1015
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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