| Asian Alcoholism (2) | |
|
14015b Sanford Ave Flushing NY 11355-2557 | |
| (718) 358-8288 | |
| (718) 358-5265 |
| Full Name | Asian Alcoholism (2) |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 14015b Sanford Ave, Flushing, New York |
| Authorized Official Name and Position | Jean M Coppola (DIRECTOR OF BILLING) |
| Authorized Official Contact | 7186517770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Asian Alcoholism (2) 6002 Queens Blvd Lower Level Woodside NY 11377-4973 Ph: (718) 651-7770 | Asian Alcoholism (2) 14015b Sanford Ave Flushing NY 11355-2557 Ph: (718) 358-8288 |
| NPI Number | 1053460774 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 12/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053460774 | NPI | - | NPPES |
| WV0071 | Other | NY | BLUE CROSS BLUE SHIELD |
| 7403085 | Other | NY | GHI |
| 00244371 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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Asian Clinic (2) Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14015b Sanford Ave, Flushing, NY 11355 Phone: 718-358-8288 Fax: 718-358-5265 |