Fort Green Rise. | |
937 Fulton St. 1st Floor Nyc NY 11238 | |
(171) 863-6001 | |
(718) 638-5167 |
Full Name | Fort Green Rise. |
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Speciality | Clinic/center - Community Health |
Location | 937 Fulton St., Nyc, New York |
Authorized Official Name and Position | Demo Pittas (CLINICAL DIRECTOR) |
Authorized Official Contact | 17186360015 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Fort Green Rise. 151 Norman Ave. Apt 2l Nyc NJ 11222 Ph: () - | Fort Green Rise. 937 Fulton St. 1st Floor Nyc NY 11238 Ph: (171) 863-6001 |
NPI Number | 1104035484 |
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Provider Enumeration Date | 05/22/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1104035484 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (New York) | Primary |