MEDICARE: ST. ANN'S CORNER OF HARM REDUCTION

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

General Provider Information

NPI Number	:	1538547476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. ANN'S CORNER OF HARM REDUCTION

Provider Business Mailing Address
First Line	:	886 WESTCHESTER AVE
Second Line	:	GROUND FLOOR SUITE
City	:	BRONX
State	:	NY
Zip	:	10459-4010
Country	:	US
Telephone Number	:	718-585-5544
Fax Number	:	718-585-8314

Provider Business Practice Location Address
First Line	:	886 WESTCHESTER AVE
Second Line	:	GROUND FLOOR SUITE
City	:	BRONX
State	:	NY
Zip	:	10459-4010
Country	:	US
Telephone Number	:	718-585-5544
Fax Number	:	718-585-8314

Authorized Official
Title or Position	:	DEPUTY & CLINICAL DIRECTOR
Name	:	DR. LAMBERTUS BART MAJOOR
Credential	:
Telephone Number	:	718-585-5544

Provider Enumeration Date	:	05/12/2015
Last Update Date	:	05/12/2015

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