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General NPI Number Information
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NPI Number | 1932349511
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Entity Type | Organization
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Legal Business Name | ST. MARY'S CENTER, INC
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 512 W 126TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-2406
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Country | US
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Telephone | 212-665-5992
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Fax | 646-619-6272
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Provider Business Mailing Address
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Address Line | 512 W 126TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-2406
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Country | US
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Telephone | 212-665-5992
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Fax | 646-619-6272
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Authorized Official
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Title or Position | CEO
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Name | HOLLY A TARIQ
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Credential |
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Telephone | 212-665-5992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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