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NPI 1649516352

NPI 1649516352 : METRO COMMUNITY HEALTH CENTERS, INC. : STATEN ISLAND, NY

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General NPI Number Information
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    NPI Number           |    1649516352
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    Entity Type          |    Organization 
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    Legal Business Name  |    METRO COMMUNITY HEALTH CENTERS, INC. 
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Dates
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    Enumeration Date     |    12/27/2012
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    Last Update Date     |    10/09/2025
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Provider Practice Location Address
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    Address Line         |    2324 FOREST AVE 
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    City                 |    STATEN ISLAND
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    State                |    NY
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    Zip                  |    10303-1506
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    Country              |    US
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    Telephone            |    718-447-0200
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    Fax                  |    718-981-1431
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Provider Business Mailing Address
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    Address Line         |    979 CROSS BRONX EXPY 
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    City                 |    BRONX
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    State                |    NY
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    Zip                  |    10460-4885
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CHIEF FINANCIAL OFFICER
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    Name                 |     FRED  WONG 
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    Credential           |    
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    Telephone            |    212-947-5770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261Q00000X
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    Taxonomy Name        |    Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QF0400X
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    Taxonomy Name        |    Federally Qualified Health Center (FQHC)
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    License Number       |    
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    License Number State |    
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