| New York City Department Of Health And Mental Hygiene Hillside Avenue | |
|
164 21 Hillside Avenue Nycdohmh Hillside Avenue Health Center Jamaica NY 11432-4140 | |
| (718) 676-2259 | |
| (718) 262-8885 |
| Full Name | New York City Department Of Health And Mental Hygiene Hillside Avenue |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 164 21 Hillside Avenue, Jamaica, New York |
| Authorized Official Name and Position | Michael James Smook (ADMINISTRATIVE MANAGER THIRD PARTY) |
| Authorized Official Contact | 2124428468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New York City Department Of Health And Mental Hygiene Hillside Avenue Po Box 74 125 Worth Street Rm 901 New York NY 10013-4006 Ph: (212) 442-8468 | New York City Department Of Health And Mental Hygiene Hillside Avenue 164 21 Hillside Avenue Nycdohmh Hillside Avenue Health Center Jamaica NY 11432-4140 Ph: (718) 676-2259 |
| NPI Number | 1285680389 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285680389 | NPI | - | NPPES |
| 00247549 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 7002112R5621 (New York) | Primary |
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