MEDICARE: THE INSTITUTES OF APPLIED HUMAN DYNAMICS, INC.

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
1	315P00000X	Intellectual Disabilities Intermediate Care Facility		NY

General Provider Information

NPI Number	:	1114371382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE INSTITUTES OF APPLIED HUMAN DYNAMICS, INC.

Provider Business Mailing Address
First Line	:	32 WARREN AVE
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-3021
Country	:	US
Telephone Number	:	914-220-4353
Fax Number	:	914-468-0352

Provider Business Practice Location Address
First Line	:	165 ESPLANADE
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10553-1116
Country	:	US
Telephone Number	:	914-220-4353
Fax Number	:	914-468-0352

Authorized Official
Title or Position	:	SENIOR BILLER
Name	:	MS. TANIESE GRIFFITHS
Credential	:
Telephone Number	:	914-220-4353

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	04/28/2016

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