| Alianza Dominicana, Inc. | |
|
715 W 179th St Basement New York NY 10033-6020 | |
| (212) 795-4226 | |
| (212) 795-4285 |
| Full Name | Alianza Dominicana, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 715 W 179th St, New York, New York |
| Authorized Official Name and Position | Moises Perez (CHIEF EXECUTIVE OFFICER/FOUNDER) |
| Authorized Official Contact | 2127401960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alianza Dominicana, Inc. 2410 Amsterdam Ave 4th Floor New York NY 10033-7320 Ph: (212) 795-4226 | Alianza Dominicana, Inc. 715 W 179th St Basement New York NY 10033-6020 Ph: (212) 795-4226 |
| NPI Number | 1568653806 |
|---|---|
| Provider Enumeration Date | 08/01/2007 |
| Last Update Date | 08/01/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568653806 | NPI | - | NPPES |
| 01765140 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 8655110A (New York) | Primary |
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