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General NPI Number Information
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NPI Number | 1053789727
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Entity Type | Organization
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Legal Business Name | ACADEMY OF MEDICAL & PUBLIC HEALTH SERVICES
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 5306 3RD AVE 2ND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-2601
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Country | US
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Telephone | 646-543-3015
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Fax |
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Provider Business Mailing Address
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Address Line | 5306 3RD AVE 2ND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-2601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | HEWETT CHIU
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Credential |
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Telephone | 646-543-3015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 72080505
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 22679314
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 1124027750
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 22663193
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2014030896
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License Number State | NY
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