Healthcare Provider Details

I. General information

NPI: 1861570517
Provider Name (Legal Business Name): JEWISH ASSOCIATION FOR SERVICES FOR THE AGED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 12/23/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 SOUTHERN BLVD
BRONX NY
10460-6262
US

IV. Provider business mailing address

247 W. 37TH ST. 9TH FLOOR
NEW YORK NY
10018-5706
US

V. Phone/Fax

Practice location:
  • Phone: 718-365-4044
  • Fax: 718-563-0715
Mailing address:
  • Phone: 212-273-5200
  • Fax: 212-695-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number7586150A
License Number StateNY

VIII. Authorized Official

Name: YAMIT ALPERN KOL
Title or Position: DIRECTOR OF CLINIC OPERATIONS
Credential:
Phone: 212-273-5272