Healthcare Provider Details

I. General information

NPI: 1508126186
Provider Name (Legal Business Name): THE INSTITUTE FOR FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 FERRIS PL STE 1
BRONX NY
10461-3611
US

IV. Provider business mailing address

CL # 4655 PO BOX 95000
PHILADELPHIA PA
19195-4655
US

V. Phone/Fax

Practice location:
  • Phone: 718-239-1610
  • Fax: 845-633-5964
Mailing address:
  • Phone: 845-255-3435
  • Fax: 845-256-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number397006
License Number StateNY

VIII. Authorized Official

Name: ERIC GAYLE
Title or Position: PRESIDENT AND CEO
Credential: MD
Phone: 212-633-0800