Healthcare Provider Details

I. General information

NPI: 1982851614
Provider Name (Legal Business Name): WESTCHESTER DISABLED ON THE MOVE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984 N BROADWAY SUITE L01
YONKERS NY
10701-1318
US

IV. Provider business mailing address

984 N BROADWAY SUITE L01
YONKERS NY
10701-1318
US

V. Phone/Fax

Practice location:
  • Phone: 914-968-4717
  • Fax: 914-968-6137
Mailing address:
  • Phone: 914-968-4717
  • Fax: 914-968-6137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MELVYN R TANZMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 914-968-4717