| Corizon | |
|
4904 19th Ave Astoria NY 11105-1002 | |
| (347) 774-7295 | |
| Not Available |
| Full Name | Corizon |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4904 19th Ave, Astoria, New York |
| Authorized Official Name and Position | Nicole Campbell (HUMAN RESOURCE SPECIALIST) |
| Authorized Official Contact | 3477747295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corizon 49-04 19 Ave Astoria NY 11105 Ph: (347) 774-7295 | Corizon 4904 19th Ave Astoria NY 11105-1002 Ph: (347) 774-7295 |
| NPI Number | 1770980252 |
|---|---|
| Provider Enumeration Date | 11/26/2014 |
| Last Update Date | 11/26/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770980252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 011517-1 (New York) | Primary |
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