Healthcare Provider Details

I. General information

NPI: 1528602893
Provider Name (Legal Business Name): NEW YORK FOUNDLING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 AVENUE OF AMERICAS 14TH FLOOR
NEW YORK NY
10011
US

IV. Provider business mailing address

590 6TH AVE # 10TH
NEW YORK NY
10011-2022
US

V. Phone/Fax

Practice location:
  • Phone: 212-206-4161
  • Fax:
Mailing address:
  • Phone: 917-485-7291
  • Fax: 917-485-7590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA MOJICA
Title or Position: BILLING CREDENTIALING MANAGER
Credential:
Phone: 917-485-7291