Organization
BASICS/PROMESA SYSTEMS INC.,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM MATTEL LMSW (COO)
(718) 299-1100
Entity
Organization
Contact information
Practice address
1776 CLAY AVENUE, BRONX, NY 10457
(718) 299-1100
Mailing address
262-4 EAST 174TH STREET, BRONX, NY 10457
(718) 299-1100
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
083184
NY
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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