| Ft. Wadsworth Family Health Center | |
|
206 Drum Rd Staten Island NY 10305-5079 | |
| (718) 442-4158 | |
| (718) 447-1325 |
| Full Name | Ft. Wadsworth Family Health Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 206 Drum Rd, Staten Island, New York |
| Authorized Official Name and Position | John Burkhart (VP & MEDICAL DIRECTOR) |
| Authorized Official Contact | 2123564903 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ft. Wadsworth Family Health Center 450 W 33rd St New York NY 10001-2603 Ph: (212) 356-4419 | Ft. Wadsworth Family Health Center 206 Drum Rd Staten Island NY 10305-5079 Ph: (718) 442-4158 |
| NPI Number | 1356675961 |
|---|---|
| Provider Enumeration Date | 09/29/2009 |
| Last Update Date | 09/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356675961 | NPI | - | NPPES |
| 00243229 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 7002037H (New York) | Primary |
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