Healthcare Provider Details

I. General information

NPI: 1437776507
Provider Name (Legal Business Name): BETANCES HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 07/06/2020
Certification Date: 07/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 HENRY STREET
NEW YORK NY
10002
US

IV. Provider business mailing address

280 HENRY STREET
NEW YORK NY
10002
US

V. Phone/Fax

Practice location:
  • Phone: 212-227-8401
  • Fax:
Mailing address:
  • Phone: 212-227-8401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DEOCHAND NARAIN
Title or Position: CFO
Credential:
Phone: 212-227-8401