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NPI Code Detail

MEDICARE: BRONX ADDICTION TREATMENT CENTER

MEDICARE: BRONX ADDICTION TREATMENT CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013099498
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRONX ADDICTION TREATMENT CENTER
Provider Business Mailing Address
First Line : 1500 WATERS PLACE
Second Line : BUILDING 13 BRONX PSYCHIATRIC CENTER
City : BRONX
State : NY
Zip : 10461-2723
Country : US
Telephone Number : 718-904-0026
Fax Number : 718-823-2048
Provider Business Practice Location Address
First Line : 1500 WATERS PLACE
Second Line : BUILDING 13 BRONX PSYCHIATRIC CENTER
City : BRONX
State : NY
Zip : 10461-2723
Country : US
Telephone Number : 718-904-0026
Fax Number : 718-823-2048
Authorized Official
Title or Position : ASSOCIATE COMMISSIONER DIVISION OF
Name : MR. MICHAEL A LAWLER
Credential :
Telephone Number : 518-457-5312
Provider Enumeration Date : 10/19/2006
Last Update Date : 08/22/2020

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Directions to “BRONX ADDICTION TREATMENT CENTER ” Practice Location

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