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NPI Code Detail

MEDICARE: COMMUNITY HEALTH ACTION OF STATEN ISLAND, INC.

MEDICARE: COMMUNITY HEALTH ACTION OF STATEN ISLAND, 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
1251S00000XCommunity/Behavioral Health Agency080311454NY
2251S00000XCommunity/Behavioral Health AgencyNY

Other Identifiers

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

General Provider Information

NPI Number : 1871793356
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH ACTION OF STATEN ISLAND, INC.
Provider Business Mailing Address
First Line : 56 BAY ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-2563
Country : US
Telephone Number : 718-808-1300
Fax Number : 718-808-1393
Provider Business Practice Location Address
First Line : 56 BAY ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-2563
Country : US
Telephone Number : 718-808-1300
Fax Number : 718-808-1393
Authorized Official
Title or Position : SNR. VP/CHIEF FISCAL OFFICER
Name : JENNIFER LYTTON
Credential :
Telephone Number : 718-808-1422
Provider Enumeration Date : 07/23/2007
Last Update Date : 04/08/2016

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Directions to “COMMUNITY HEALTH ACTION OF STATEN ISLAND, INC. ” Practice Location

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