| Association To Benefit Children | |
|
1841 Park Ave 3rd Floor New York NY 10035-1316 | |
| (646) 459-6166 | |
| (646) 459-6086 |
| Full Name | Association To Benefit Children |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1841 Park Ave, New York, New York |
| Authorized Official Name and Position | Gretchen Buchenholz (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2128453821 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Association To Benefit Children 419 E 86th St New York NY 10028-6402 Ph: (212) 845-3821 | Association To Benefit Children 1841 Park Ave 3rd Floor New York NY 10035-1316 Ph: (646) 459-6166 |
| NPI Number | 1013102565 |
|---|---|
| Provider Enumeration Date | 09/07/2007 |
| Last Update Date | 12/19/2007 |
| Medicare PECOS PAC ID | 5890071104 |
|---|---|
| Medicare Enrollment ID | O20190806000775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013102565 | NPI | - | NPPES |
| 02903597 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 9204120A (New York) | Primary |
| Provider Name | Adam Z Leczycki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316195514 PECOS PAC ID: 9638127632 Enrollment ID: I20190809000579 |
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