MEDICARE: NEIGHBORHOOD COALITION FOR SHELTER

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	261QM1300X	Multi-Specialty Clinic/Center	180811623	NY

General Provider Information

NPI Number	:	1669916649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD COALITION FOR SHELTER

Provider Business Mailing Address
First Line	:	921 MADISON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3508
Country	:	US
Telephone Number	:	917-677-0724
Fax Number	:	212-879-5328

Provider Business Practice Location Address
First Line	:	921 MADISON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3508
Country	:	US
Telephone Number	:	917-677-0724
Fax Number	:	212-879-5328

Authorized Official
Title or Position	:	SOCIAL WORKER
Name	:	MRS. EMILY JOHNSON
Credential	:	MSW
Telephone Number	:	917-677-0724

Provider Enumeration Date	:	12/12/2016
Last Update Date	:	12/12/2016

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Directions to “NEIGHBORHOOD COALITION FOR SHELTER ” Practice Location

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