Healthcare Provider Details
I. General information
NPI: 1770521270
Provider Name (Legal Business Name): HEALTH CARE CHOICES NY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2006
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6209 16TH AVE
BROOKLYN NY
11204-2702
US
IV. Provider business mailing address
6209 16TH AVE
BROOKLYN NY
11204-2702
US
V. Phone/Fax
- Phone: 718-234-0073
- Fax: 718-236-8456
- Phone: 718-234-0073
- Fax: 718-236-8456
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | 7001299R |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | 7001299R |
| License Number State | NY |
VIII. Authorized Official
Name:
MARIA
SIEBEL
Title or Position: CEO
Credential: LCSW
Phone: 718-234-0073