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NPI Code Detail

MEDICARE: THE CHILD CENTER OF NY

MEDICARE: THE CHILD CENTER OF NY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0855XAdolescent and Children Mental Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27403085OTHERNYGHI
3WV0071OTHERNYBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1104975200
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CHILD CENTER OF NY
Provider Business Mailing Address
First Line : 6002 QUEENS BLVD
Second Line : LOWER LEVEL
City : WOODSIDE
State : NY
Zip : 11377-4973
Country : US
Telephone Number : 718-651-7770
Fax Number : 718-651-5029
Provider Business Practice Location Address
First Line : 7150 PARSONS BLVD
Second Line :
City : FLUSHING
State : NY
Zip : 11365-4131
Country : US
Telephone Number : 718-591-6750
Fax Number : 718-591-4397
Authorized Official
Title or Position : BILLING MANAGER
Name : MS. JEAN M COPPOLA
Credential :
Telephone Number : 718-651-7770
Provider Enumeration Date : 01/09/2007
Last Update Date : 07/26/2007

Similar Medicare Providers

1487709945 — PROF. SELINE L BEARMAN LCSW
Practice Location Address:
7150 PARSONS BLVD
FLUSHING, NY
11365-4131
Practice Phone: 718-591-6750
Practice Fax: 718-591-4397
1205982493 — MS. MARIA MCLAREN LCSW
Practice Location Address:
7150 PARSONS BLVD , CHILD CENTER OF NEW YORK
FLUSHING, NY
11365-4131
Practice Phone: 718-591-6750
Practice Fax:
1104963628 — MRS. ALLA WEINSTEIN LCSW
Practice Location Address:
7150 PARSONS BLVD
FLUSHING, NY
11365-4131
Practice Phone: 718-591-6750
Practice Fax: 718-591-4397
1700923232 — AVRILL M BLONDELL MSW
Practice Location Address:
7150 PARSONS BLVD
FLUSHING, NY
11365-4131
Practice Phone: 718-591-6750
Practice Fax:
1699970483 — MISS LISA REBECCA FOGEL M.S.W.
Practice Location Address:
7150 PARSONS BLVD
FLUSHING, NY
11365-4131
Practice Phone: 718-591-6750
Practice Fax: 718-591-4397
1740487735 — NAOMI MAX MSW
Practice Location Address:
7150 PARSONS BLVD
FLUSHING, NY
11365-4131
Practice Phone: 718-591-6750
Practice Fax: 718-591-4397

Directions to “THE CHILD CENTER OF NY ” Practice Location

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