Organization
THE CHILD CENTER OF NY, INC.
Active
Other names
Flushing Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEAN M COPPOLA (DIRECTOR OF BILLING)
(718) 651-7770
Entity
Organization
Contact information
Practice address
14015B SANFORD AVE, 2ND FLOOR, FLUSHING, NY 11355-2557
(718) 358-8288
(718) 358-5265
Mailing address
6002 QUEENS BLVD, LOWER LEVEL, WOODSIDE, NY 11377-4973
(718) 651-7770
(718) 651-5029
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
12/19/2013
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