Healthcare Provider Details

I. General information

NPI: 1942008305
Provider Name (Legal Business Name): MOUNT VERNON NEIGHBORHOOD HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 OPERATIONS DR
VALHALLA NY
10595-1586
US

IV. Provider business mailing address

107 W 4TH ST
MOUNT VERNON NY
10550-4002
US

V. Phone/Fax

Practice location:
  • Phone: 914-231-4277
  • Fax:
Mailing address:
  • Phone: 914-699-7200
  • Fax: 914-699-0837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MAXINE LEWIS
Title or Position: DIRECTOR PATIENT FINANCIAL SERVICES
Credential:
Phone: 914-699-7200