| Newtown High School | |
|
4801 90th St Room 368 Elmhurst NY 11373-4015 | |
| (718) 589-2440 | |
| Not Available |
| Full Name | Newtown High School |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4801 90th St, Elmhurst, New York |
| Authorized Official Name and Position | Paloma Hernandez (PRESIDENT AND CEO) |
| Authorized Official Contact | 7185892440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Newtown High School 1065 Southern Blvd Bronx NY 10459-2417 Ph: (718) 589-2440 | Newtown High School 4801 90th St Room 368 Elmhurst NY 11373-4015 Ph: (718) 589-2440 |
| NPI Number | 1689118077 |
|---|---|
| Provider Enumeration Date | 12/05/2016 |
| Last Update Date | 12/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689118077 | NPI | - | NPPES |
| W03211 | Other | NY | PTAN |
| 02994952 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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