Healthcare Provider Details

I. General information

NPI: 1194304907
Provider Name (Legal Business Name): UNION COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E 188TH ST
BRONX NY
10458-5302
US

IV. Provider business mailing address

260 E 188TH ST
BRONX NY
10458-5302
US

V. Phone/Fax

Practice location:
  • Phone: 718-618-8359
  • Fax: 718-960-6290
Mailing address:
  • Phone: 718-960-3399
  • Fax: 718-960-6290

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: DEAN BERTONE
Title or Position: AVP OF FINANCE
Credential:
Phone: 718-618-8359