Healthcare Provider Details

I. General information

NPI: 1134135692
Provider Name (Legal Business Name): UNION HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 7TH AVE 4TH FL
NEW YORK NY
10001-6708
US

IV. Provider business mailing address

275 7TH AVE 4TH FL
NEW YORK NY
10001-6708
US

V. Phone/Fax

Practice location:
  • Phone: 212-924-2510
  • Fax: 212-812-3564
Mailing address:
  • Phone: 212-924-2510
  • Fax: 212-812-3564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number004273
License Number StateNY

VIII. Authorized Official

Name: MARIA PITARO
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 212-924-2510