MEDICARE: PUERTO RICAN FAMILY INSTITUTE, 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	251S00000X	Community/Behavioral Health Agency	6758300A	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1285800508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUERTO RICAN FAMILY INSTITUTE, INC.

Provider Business Mailing Address
First Line	:	145 W 15TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-6701
Country	:	US
Telephone Number	:	212-924-6320
Fax Number	:	212-691-5635

Provider Business Practice Location Address
First Line	:	442 E HOUSTON ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-1122
Country	:	US
Telephone Number	:	212-400-9436
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. MARIA ELENA GIRONE
Credential	:
Telephone Number	:	212-924-6320

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	05/07/2008

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