Healthcare Provider Details

I. General information

NPI: 1801030481
Provider Name (Legal Business Name): ALBERT EINSTEIN COLLEGE OF MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 210TH ST ADULT OUTPATIENT PSYCHIATRY DEPARTMENT
BRONX NY
10467-2401
US

IV. Provider business mailing address

3850 HUDSON MANOR TER APT 3AW
BRONX NY
10463-1117
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-7837
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: ELISHEVA BERMAN
Title or Position: RESIDENT
Credential:
Phone: 718-920-7837