Healthcare Provider Details

I. General information

NPI: 1013279314
Provider Name (Legal Business Name): NEW YORK CHILD RESOURCE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 06/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 E 146TH ST
BRONX NY
10451-5702
US

IV. Provider business mailing address

348 E 146TH ST
BRONX NY
10451-5702
US

V. Phone/Fax

Practice location:
  • Phone: 718-585-0600
  • Fax: 718-585-0152
Mailing address:
  • Phone: 718-585-0600
  • Fax: 718-585-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KARIN ANGELINA PEREZ
Title or Position: SERVICE COORDINATOR
Credential:
Phone: 718-585-0600