MEDICARE: LINCOLN MEDICAL AND 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	282N00000X	General Acute Care Hospital	219939	NY

General Provider Information

NPI Number	:	1558433466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINCOLN MEDICAL AND MENTAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	324 E 149TH ST
Second Line	:	EMERGENCY DEPT
City	:	BRONX
State	:	NY
Zip	:	10451
Country	:	US
Telephone Number	:	718-579-6011
Fax Number	:	718-579-4822

Provider Business Practice Location Address
First Line	:	324 E 149TH ST
Second Line	:	EMERGENCY DEPT
City	:	BRONX
State	:	NY
Zip	:	10451-5602
Country	:	US
Telephone Number	:	718-579-6011
Fax Number	:	718-579-4822

Authorized Official
Title or Position	:	MD
Name	:	KARLENE HOSFORD
Credential	:
Telephone Number	:	718-579-6011

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	08/22/2020

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