| Susan's Place Health Center | |
|
1921 Jerome Avenue Bronx NY 10453-5707 | |
| (718) 943-1341 | |
| (718) 716-3754 |
| Full Name | Susan's Place Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1921 Jerome Avenue, Bronx, New York |
| Authorized Official Name and Position | John Chue (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2123664459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan's Place Health Center 30 E 33rd St 5th Floor New York NY 10016-5337 Ph: (212) 366-4459 | Susan's Place Health Center 1921 Jerome Avenue Bronx NY 10453-5707 Ph: (718) 943-1341 |
| NPI Number | 1013154657 |
|---|---|
| Provider Enumeration Date | 01/20/2009 |
| Last Update Date | 05/10/2024 |
| Medicare PECOS PAC ID | 9830240332 |
|---|---|
| Medicare Enrollment ID | O20090623000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013154657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7000279R (New York) | Primary |
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