Healthcare Provider Details

I. General information

NPI: 1568915189
Provider Name (Legal Business Name): CHDFS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 08/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 W 38TH ST SUITE 817
NEW YORK NY
10018-2913
US

IV. Provider business mailing address

307 W 38TH ST SUITE 817
NEW YORK NY
10018-2913
US

V. Phone/Fax

Practice location:
  • Phone: 212-695-4564
  • Fax: 212-695-4561
Mailing address:
  • Phone: 212-695-4564
  • Fax: 212-695-4561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIO E. BARROS
Title or Position: CEO
Credential: CSW, PHD
Phone: 212-695-4562