MEDICARE: NEIGHBORHOOD COALITION FOR SHELTER INC.

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
1	261QP2300X	Primary Care Clinic/Center		NY

General Provider Information

NPI Number	:	1104095322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD COALITION FOR SHELTER INC.

Provider Business Mailing Address
First Line	:	157 E 86TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-2175
Country	:	US
Telephone Number	:	212-537-5100
Fax Number	:	212-860-2301

Provider Business Practice Location Address
First Line	:	921 MADISON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3508
Country	:	US
Telephone Number	:	212-249-6429
Fax Number	:	212-794-0129

Authorized Official
Title or Position	:	DIRECTOR
Name	:	THOMAS ON'EALLL
Credential	:	LMSW
Telephone Number	:	212-249-6429

Provider Enumeration Date	:	02/21/2008
Last Update Date	:	02/21/2008

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