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General NPI Number Information
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NPI Number | 1972059467
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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 | 08/25/2016
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 177 LIVINGSTON ST LOWER LEVEL
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City | BROOKLYN
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State | NY
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Zip | 11201-7000
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Country | US
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Telephone | 718-855-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 40 RECTOR ST FL 15
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City | NEW YORK
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State | NY
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Zip | 10006-1722
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Country | US
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Telephone | 212-947-5770
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Fax | 212-356-1348
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Authorized Official
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Title or Position | CFO
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Name | MR. 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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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