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NPI Code Detail

MEDICARE: SOHO COMMUNITY CLINIC

MEDICARE: SOHO COMMUNITY CLINIC
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
1261QV0200XVA Clinic/Center

General Provider Information

NPI Number : 1174563548
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOHO COMMUNITY CLINIC
Provider Business Mailing Address
First Line : 245 W HOUSTON ST
Second Line : ROOM 313
City : NEW YORK
State : NY
Zip : 10014-4805
Country : US
Telephone Number : 212-337-2569
Fax Number : 212-337-2537
Provider Business Practice Location Address
First Line : 245 W HOUSTON ST
Second Line : ROOM 313
City : NEW YORK
State : NY
Zip : 10014-4805
Country : US
Telephone Number : 212-337-2569
Fax Number : 212-337-2537
Authorized Official
Title or Position : DIRECTOR, BUSINESS DEVELOPMENT
Name : BARBARA MAYERICK
Credential :
Telephone Number : 202-254-0339
Provider Enumeration Date : 06/07/2006
Last Update Date : 08/22/2020

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Directions to “SOHO COMMUNITY CLINIC ” Practice Location

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