MEDICARE: PUBLIC HEALTH SOLUTIONS

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	261QC1500X	Community Health Clinic/Center	7002296R	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851582506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIC HEALTH SOLUTIONS

Provider Business Mailing Address
First Line	:	220 CHURCH ST
Second Line	:	5TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10013-2904
Country	:	US
Telephone Number	:	646-619-6400
Fax Number	:	646-619-6782

Provider Business Practice Location Address
First Line	:	534 W 135TH ST
Second Line	:	2ND FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10031-8601
Country	:	US
Telephone Number	:	212-283-5542
Fax Number	:	212-283-4631

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. ELLEN RAUTENBERG
Credential	:
Telephone Number	:	646-619-6401

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	08/04/2008

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Directions to “PUBLIC HEALTH SOLUTIONS ” Practice Location

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