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General NPI Number Information
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NPI Number | 1861770547
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Entity Type | Organization
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Legal Business Name | SELFHELP ALZHEIMERS RESOURCE PROGRAM
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 07/28/2011
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Provider Practice Location Address
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Address Line | 520 EIGHTH AVENUE
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City | NEW YORK
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State | NY
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Zip | 10018-6553
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Country | US
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Telephone | 212-971-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 520 EIGHTH AVENUE
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City | NEW YORK
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State | NY
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Zip | 10018-6553
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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 | VICE PRESIDENT, ADMINISTRATION
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Name | MR. RUSSELL LUSAK
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Credential |
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Telephone | 212-971-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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