Healthcare Provider Details

I. General information

NPI: 1538204250
Provider Name (Legal Business Name): SOUND VIEW THROGS NECK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2527 GLEBE AVE
BRONX NY
10461-3109
US

IV. Provider business mailing address

2527 GLEBE AVE
BRONX NY
10461-3109
US

V. Phone/Fax

Practice location:
  • Phone: 718-904-4454
  • Fax: 718-904-4480
Mailing address:
  • Phone: 718-904-4454
  • Fax: 718-904-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number00759944
License Number StateNY

VIII. Authorized Official

Name: KEVIN RHONE
Title or Position: MEDICAID AND FINANCIAL LIASION
Credential:
Phone: 718-904-4454