Healthcare Provider Details
I. General information
NPI: 1295729408
Provider Name (Legal Business Name): THE INSTITUTE FOR FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2005
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16 E 16TH ST
NEW YORK NY
10003-3105
US
IV. Provider business mailing address
TD CL#4655 PO BOX 95000
PHILADELPHIA PA
19195-4655
US
V. Phone/Fax
- Phone: 212-633-0800
- Fax: 212-691-4610
- Phone: 845-255-3766
- Fax: 845-255-3753
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | 127500 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
GAYLE
Title or Position: PRESIDENT AND CEO
Credential: MD
Phone: 212-633-0800