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General NPI Number Information
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NPI Number | 1235323502
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICES OF NEW YORK
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 475 RIVERSIDE DR SUITE 1244
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City | NEW YORK
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State | NY
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Zip | 10115-0002
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Country | US
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Telephone | 212-870-1171
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Fax | 212-870-1105
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Provider Business Mailing Address
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Address Line | 475 RIVERSIDE DRIVE SUITE 1244
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City | NEW YORK CITY
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State | NY
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Zip | 10115-0037
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Country | US
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Telephone | 212-870-1171
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Fax | 212-870-1105
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Authorized Official
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Title or Position | MEDICAL ASSURANCE COORDINATOR
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Name | MRS. SELENA SAMUELS
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Credential |
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Telephone | 212-870-1171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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