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General NPI Number Information
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NPI Number | 1770774424
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Entity Type | Organization
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Legal Business Name | PUBLIC HEALTH SOLUTIONS
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 335 CENTRAL AVE 2ND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11221-4501
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Country | US
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Telephone | 718-443-9300
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Fax | 718-919-6153
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Provider Business Mailing Address
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Address Line | 220 CHURCH ST 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10013-2904
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Country | US
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Telephone | 646-619-6400
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Fax | 646-619-6782
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | PROF. ELLEN RAUTENBERG
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Credential |
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Telephone | 646-619-6401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 7002296R
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License Number State | NY
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