Healthcare Provider Details

I. General information

NPI: 1346232345
Provider Name (Legal Business Name): UNIVERSITY SETTLEMENT SOCIETY OF NEW YORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 ELDRIDGE ST
NEW YORK NY
10002-2924
US

IV. Provider business mailing address

184 ELDRIDGE ST
NEW YORK NY
10002-2924
US

V. Phone/Fax

Practice location:
  • Phone: 212-674-9120
  • Fax: 212-254-5334
Mailing address:
  • Phone: 212-453-4505
  • Fax: 212-777-0445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LISA I JONES
Title or Position: BUSINESS MANAGER
Credential:
Phone: 212-453-4522