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General NPI Number Information
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NPI Number | 1235479114
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Entity Type | Organization
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Legal Business Name | MORIJA MULTICULTURAL COMMUNITY CENTER
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 314 W 120TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-6127
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Country | US
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Telephone | 212-663-7661
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Fax | 718-874-0145
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Provider Business Mailing Address
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Address Line | 314 W 120TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-6127
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Country | US
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Telephone | 212-663-7661
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Fax | 718-874-0145
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Authorized Official
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Title or Position | FIRST ELDER
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Name | MR. ERNST FLEURANVIL
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Credential | PROFESSIONAL ENGINEE
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Telephone | 347-339-6688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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