=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568333128
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NYC HEALTH AND HOSPITALS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2025
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 506 LENOX AVE STE 15-100
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10037-1889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-939-8557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 506 LENOX AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10037-1889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-939-8557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROGRAM MANAGER
-----------------------------------------------------
Name | TAYLOR AVERY
-----------------------------------------------------
Credential | MS
-----------------------------------------------------
Telephone | 212-939-8557
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1744R1102X
-----------------------------------------------------
Taxonomy Name | Research Study Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------