Healthcare Provider Details

I. General information

NPI: 1912442674
Provider Name (Legal Business Name): TRANSITIONAL CARE MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 3RD AVE STE 2A
NEW YORK NY
10128-3623
US

IV. Provider business mailing address

PO BOX 286500
NEW YORK NY
10128-0005
US

V. Phone/Fax

Practice location:
  • Phone: 718-734-0000
  • Fax: 347-590-7330
Mailing address:
  • Phone: 718-734-0000
  • Fax: 347-590-7330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number153318
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number114479
License Number StateNY

VIII. Authorized Official

Name: MS. RENEE SPRINGER
Title or Position: SUPERVISOR
Credential:
Phone: 718-734-0000