MEDICARE: LINCOLN MEDICAL MENTAL HEALTH 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
1	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1194861179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINCOLN MEDICAL MENTAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	234 E 149TH ST 10-C
Second Line	:	BRONX NEW YORK
City	:	NEW YORK
State	:	NY
Zip	:	10451
Country	:	US
Telephone Number	:	718-579-5000
Fax Number	:	718-579-5284

Provider Business Practice Location Address
First Line	:	234 E 149TH ST 10-C
Second Line	:	BRONX NEW YORK
City	:	NEW YORK
State	:	NY
Zip	:	10451
Country	:	US
Telephone Number	:	718-579-5000
Fax Number	:	718-579-5284

Authorized Official
Title or Position	:	PSYCHIATRIC RESIDENT LEVEL IV
Name	:	DR. SOCRATES CASTILLO SR.
Credential	:	MD
Telephone Number	:	718-579-5000

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	08/22/2020

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