Healthcare Provider Details

I. General information

NPI: 1528142932
Provider Name (Legal Business Name): HUNTS POINT MULTI-SERVICE CENTER., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

754 E 151ST ST SAME
BRONX NY
10455-3267
US

IV. Provider business mailing address

754 E 151ST ST SAME
BRONX NY
10455-3267
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-5444
  • Fax: 718-993-5993
Mailing address:
  • Phone: 718-401-5444
  • Fax: 718-993-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number13261253
License Number StateNY

VIII. Authorized Official

Name: MR. MANUEL A ROSA SR.
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 718-401-5444