| Bliss-poston The Second Wind, Inc. | |
|
928 Broadway Suite 403 New York NY 10010-8151 | |
| (212) 481-1055 | |
| (212) 481-7374 |
| Full Name | Bliss-poston The Second Wind, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 928 Broadway, New York, New York |
| Authorized Official Name and Position | John Bliss (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2124811055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bliss-poston The Second Wind, Inc. 928 Broadway Suite 403 New York NY 10010-8151 Ph: (212) 481-1055 | Bliss-poston The Second Wind, Inc. 928 Broadway Suite 403 New York NY 10010-8151 Ph: (212) 481-1055 |
| NPI Number | 1033216098 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 10/22/2014 |
| Medicare PECOS PAC ID | 3274424395 |
|---|---|
| Medicare Enrollment ID | O20101105000786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033216098 | NPI | - | NPPES |
| 01427467 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | John Bliss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811094899 PECOS PAC ID: 0143415943 Enrollment ID: I20111227000655 |
| Provider Name | Monica Ann Starr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770868085 PECOS PAC ID: 5698906022 Enrollment ID: I20230920002671 |
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