Healthcare Provider Details

I. General information

NPI: 1063803104
Provider Name (Legal Business Name): HEALTH AND HOSPITAL COORPERATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9012 218TH PL
QUEENS VILLAGE NY
11428-1337
US

IV. Provider business mailing address

9012 218TH PL
QUEENS VILLAGE NY
11428-1337
US

V. Phone/Fax

Practice location:
  • Phone: 718-778-9556
  • Fax:
Mailing address:
  • Phone: 718-778-9556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number6207331
License Number StateNY

VIII. Authorized Official

Name: MRS. MONICA MARIE WHITE-WILLIAMS
Title or Position: RN
Credential:
Phone: 718-778-9556