MEDICARE: HARLEM HOSPITAL 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	283Q00000X	Psychiatric Hospital	070474	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070474	OTHER	NY	LMSW

General Provider Information

NPI Number	:	1982756227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARLEM HOSPITAL CENTER

Provider Business Mailing Address
First Line	:	1751 2ND AVE
Second Line	:	28T
City	:	NEW YORK
State	:	NY
Zip	:	10128-5363
Country	:	US
Telephone Number	:	212-534-6742
Fax Number	:

Provider Business Practice Location Address
First Line	:	1751 2ND AVE
Second Line	:	28T
City	:	NEW YORK
State	:	NY
Zip	:	10128-5363
Country	:	US
Telephone Number	:	212-534-6742
Fax Number	:

Authorized Official
Title or Position	:	SOCIAL WORK SUPERVISOR
Name	:	MRS. IVONA MERLE CRAWFORD
Credential	:	LMSW
Telephone Number	:	212-939-3355

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	08/22/2020

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