Healthcare Provider Details

I. General information

NPI: 1194861179
Provider Name (Legal Business Name): LINCOLN MEDICAL MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST 10-C BRONX NEW YORK
NEW YORK NY
10451
US

IV. Provider business mailing address

234 E 149TH ST 10-C BRONX NEW YORK
NEW YORK NY
10451
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5000
  • Fax: 718-579-5284
Mailing address:
  • Phone: 718-579-5000
  • Fax: 718-579-5284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. SOCRATES CASTILLO SR.
Title or Position: PSYCHIATRIC RESIDENT LEVEL IV
Credential: MD
Phone: 718-579-5000