| Sound View Throgs Neck Community Mental Health Center | |
|
2527 Glebe Avenue Bronx NY 10461 | |
| (718) 904-4420 | |
| (718) 931-7307 |
| Full Name | Sound View Throgs Neck Community Mental Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2527 Glebe Avenue, Bronx, New York |
| Authorized Official Name and Position | Emanuel Genn (ASSOCIATE DEAN FOR BUSINESS AFFAIRS) |
| Authorized Official Contact | 7184303182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sound View Throgs Neck Community Mental Health Center 1300 Morris Park Avenue Bronx NY 10461 Ph: (718) 904-4420 | Sound View Throgs Neck Community Mental Health Center 2527 Glebe Avenue Bronx NY 10461 Ph: (718) 904-4420 |
| NPI Number | 1962593210 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 10/04/2011 |
| Medicare PECOS PAC ID | 8426947797 |
|---|---|
| Medicare Enrollment ID | O20040313000688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962593210 | NPI | - | NPPES |
| 041210000000 | Other | FIDELIS ID# | |
| 3106231 | Other | GHI PROVIDER # | |
| 00759944 | Medicaid | NY | |
| 04121000000 | Other | CENTER CARE ID # | |
| 1037430 | Other | BEACON PROV # | |
| 142975 | Other | VALUEOPTIONS PROVIDER # | |
| 251311 | Other | COMP PSYCH ID # | |
| 118353 | Other | HARMONY PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joanne F Siegel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861519803 PECOS PAC ID: 1355414004 Enrollment ID: I20080714000714 |
| Provider Name | Lilia A Evangelista |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932158862 PECOS PAC ID: 1759563703 Enrollment ID: I20110311000358 |
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