Healthcare Provider Details

I. General information

NPI: 1598770018
Provider Name (Legal Business Name): PROJECT RENEWAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 EAST THIRD STREET
NEW YORK NY
10003-4810
US

IV. Provider business mailing address

200 VARICK ST
NEW YORK NY
10014-4810
US

V. Phone/Fax

Practice location:
  • Phone: 212-620-0340
  • Fax: 212-633-1410
Mailing address:
  • Phone: 212-620-0340
  • Fax: 212-633-1410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0207X
TaxonomyMobile Mammography Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVEN JONES
Title or Position: CHIEF FINANCIAL AND ADMINISTRATIVE
Credential:
Phone: 212-620-0340