| Icl | |
|
40 Rector St New York NY 10006-1705 | |
| (212) 385-3030 | |
| Not Available |
| Full Name | Icl |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 40 Rector St, New York, New York |
| Authorized Official Name and Position | Dewey Howard (CFO) |
| Authorized Official Contact | 2123853030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icl 40 Rector St New York NY 10006-1705 Ph: () - | Icl 40 Rector St New York NY 10006-1705 Ph: (212) 385-3030 |
| NPI Number | 1467775031 |
|---|---|
| Provider Enumeration Date | 03/10/2010 |
| Last Update Date | 03/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467775031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 77201001 (New York) | Primary |
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