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General NPI Number Information
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NPI Number | 1255586459
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Entity Type | Organization
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Legal Business Name | FORDHAM TREMONT COMMUNIYT MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 2250 RYER AVE
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City | BRONX
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State | NY
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Zip | 10457-1104
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Country | US
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Telephone | 718-960-0617
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Fax |
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Provider Business Mailing Address
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Address Line | 4239 BOYD AVE
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City | BRONX
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State | NY
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Zip | 10466-2003
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Country | US
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Telephone | 347-920-4281
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | MS. TAMMY F. HOLLAND
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Credential | MSW
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Telephone | 347-920-4281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | CLINICIAN
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License Number State | NY
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