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NPI Code Detail

MEDICARE: CREATE, INC.

MEDICARE: CREATE, 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
1261QR0405XSubstance Use Disorder Rehabilitation 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

General Provider Information

NPI Number : 1174620314
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREATE, INC.
Provider Business Mailing Address
First Line : 760 E 160TH ST
Second Line :
City : BRONX
State : NY
Zip : 10456-7815
Country : US
Telephone Number : 718-401-5700
Fax Number : 718-993-5308
Provider Business Practice Location Address
First Line : 73 MALCOLM X BLVD
Second Line :
City : NEW YORK
State : NY
Zip : 10026-3007
Country : US
Telephone Number : 212-663-1596
Fax Number : 929-730-7480
Authorized Official
Title or Position : CHIEF STRATEGY OFFICER
Name : MR. DANIEL LOWY
Credential : LCSW
Telephone Number : 718-401-5650
Provider Enumeration Date : 09/20/2006
Last Update Date : 05/20/2026

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Directions to “CREATE, INC. ” Practice Location

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