| Community Healthcare Network, Inc. | |
|
36-11 21st St Long Island City NY 11106 | |
| (718) 482-7772 | |
| (718) 482-4698 |
| Full Name | Community Healthcare Network, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 36-11 21st St, Long Island City, New York |
| Authorized Official Name and Position | Alan J. Wengrofsky (CFO/VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 2125452481 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Healthcare Network, Inc. 60 Madison Ave Floor 5 New York NY 10010-1600 Ph: (212) 545-2439 | Community Healthcare Network, Inc. 36-11 21st St Long Island City NY 11106 Ph: (718) 482-7772 |
| NPI Number | 1952542771 |
|---|---|
| Provider Enumeration Date | 03/09/2009 |
| Last Update Date | 07/23/2018 |
| Medicare PECOS PAC ID | 7416855143 |
|---|---|
| Medicare Enrollment ID | O20120214000365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952542771 | NPI | - | NPPES |
| 00695941 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (New York) | Primary |
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