Organization
PROJECT RENEWAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCHELL NETBURN (CEO)
(212) 620-0340
Entity
Organization
Contact information
Practice address
200 VARICK ST, NEW YORK, NY 10014-4810
(212) 620-0340
(212) 633-9044
Mailing address
8 E 3RD ST, NEW YORK, NY 10003-8908
(212) 533-8400
(212) 777-6081
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
NY
Other
Enumeration date
12/30/2011
Last updated
07/21/2022
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