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General NPI Number Information
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NPI Number | 1346566262
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Entity Type | Organization
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Legal Business Name | NEW YORK PREBYSTERIAN MEDICAL CENTER
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 04/16/2010
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Provider Practice Location Address
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Address Line | 45 FAIRVIEW AVE APT 7H
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City | NEW YORK
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State | NY
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Zip | 10040-2755
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Country | US
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Telephone | 212-932-5355
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Fax | 212-932-5161
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Provider Business Mailing Address
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Address Line | 45 FAIRVIEW AVE APT 7H
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City | NEW YORK
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State | NY
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Zip | 10040-2755
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Country | US
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Telephone | 212-932-5355
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Fax | 212-932-5161
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MRS. DEYANIRA PENA-MARTINEZ
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Credential | LMSW
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Telephone | 212-942-0414
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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 | 066512-1
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License Number State | NY
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