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General NPI Number Information
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NPI Number | 1235278698
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Entity Type | Organization
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Legal Business Name | MIDDLETOWN COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10 BENTON AVE
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City | MIDDLETOWN
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State | NY
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Zip | 10940-5149
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Country | US
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Telephone | 845-343-8838
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Fax | 845-343-7017
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Provider Business Mailing Address
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Address Line | 10 BENTON AVENUE
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City | MIDDLETOWN
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State | NY
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Zip | 10940
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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 | CEO
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Name | THERESA MALONEY
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Credential |
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Telephone | 845-383-7614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number | F000279-1
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License Number State | NY
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