| Jasa | |
|
1 Fordham Plaza Suite 908 Bronx NY 10458-5871 | |
| (718) 365-4044 | |
| (718) 563-0715 |
| Full Name | Jasa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Fordham Plaza, Bronx, New York |
| Authorized Official Name and Position | Yamit Alpern Kol (DIRECTOR OF CLINIC OPERATIONS) |
| Authorized Official Contact | 2122735272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jasa 247 W. 37th St. 9th Floor New York NY 10018-5706 Ph: (212) 273-5200 | Jasa 1 Fordham Plaza Suite 908 Bronx NY 10458-5871 Ph: (718) 365-4044 |
| NPI Number | 1861570517 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7810886264 |
|---|---|
| Medicare Enrollment ID | O20040312001050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861570517 | NPI | - | NPPES |
| 00848164 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 7586150A (New York) | Primary |
| Provider Name | Shlomit Fuhrer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639114564 PECOS PAC ID: 5698770592 Enrollment ID: I20060928000037 |
| Provider Name | Claudia C Soddano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275644148 PECOS PAC ID: 3971500091 Enrollment ID: I20061103000068 |
| Provider Name | Evelyn M Howanitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831289073 PECOS PAC ID: 8527155894 Enrollment ID: I20071102000339 |
| Provider Name | Mitchell P Butin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891771374 PECOS PAC ID: 5799860698 Enrollment ID: I20090113000416 |
| Provider Name | Hilda Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164687380 PECOS PAC ID: 2668520859 Enrollment ID: I20090428000004 |
| Provider Name | Michele Mangieri Rosen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467666842 PECOS PAC ID: 7113184714 Enrollment ID: I20120209000626 |
| Provider Name | Deborah Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285716498 PECOS PAC ID: 1850694134 Enrollment ID: I20160120001193 |
| Provider Name | Julie Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083031272 PECOS PAC ID: 4587968516 Enrollment ID: I20160211000265 |
| Provider Name | Frema F Kuper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972045052 PECOS PAC ID: 2365723111 Enrollment ID: I20170110001256 |
| Provider Name | Yudelka Pena |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184002719 PECOS PAC ID: 5991102840 Enrollment ID: I20210921000886 |
| Provider Name | Charlene Humber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942607908 PECOS PAC ID: 8729437959 Enrollment ID: I20231213000242 |
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