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General NPI Number Information
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NPI Number | 1245652775
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Entity Type | Organization
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Legal Business Name | NEW YORK FOUNDLING
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 02/26/2014
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Provider Practice Location Address
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Address Line | 590 AVE OF THE AMERICAS 590 AVE OF THE AMERICAS
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City | NEW YORK
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State | NY
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Zip | 10011-2019
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Country | US
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Telephone | 212-660-1380
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Fax |
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Provider Business Mailing Address
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Address Line | 590 AVE OF THE AMERICAS 27 CHRISTOPHER STREET
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City | NEW YORK
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State | NY
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Zip | 10011-2019
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Country | US
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Telephone | 212-660-1380
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Fax |
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Authorized Official
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Title or Position | MULTI-SYSTEMIC THERAPIST
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Name | SHANE KING
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Credential |
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Telephone | 347-913-2959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 091304-1
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License Number State | NY
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