| Odyssey House, Inc | |
|
219 E 121st St New York NY 10035-3018 | |
| (212) 361-5139 | |
| (212) 361-5100 |
| Full Name | Odyssey House, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 219 E 121st St, New York, New York |
| Authorized Official Name and Position | Daryl B Everett (CONTROLLER) |
| Authorized Official Contact | 2123611678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Odyssey House, Inc 95 Pine St 17th Floor New York NY 10005-1769 Ph: (212) 361-1678 | Odyssey House, Inc 219 E 121st St New York NY 10035-3018 Ph: (212) 361-5139 |
| NPI Number | 1013976976 |
|---|---|
| Provider Enumeration Date | 03/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2264323393 |
|---|---|
| Medicare Enrollment ID | O20160513000860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013976976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 01399760 (New York) | Primary |
| Provider Name | Thomas A Yared |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205866571 PECOS PAC ID: 6709804305 Enrollment ID: I20051102000642 |
| Provider Name | Leigh-ann Borriello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043660376 PECOS PAC ID: 3971864380 Enrollment ID: I20180228000440 |
| Provider Name | Mary C Callahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164877643 PECOS PAC ID: 1052672060 Enrollment ID: I20180307000970 |
Dr Tuyen T Trinh, D.o.,pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 118 Baxter St, Room 502, New York, NY 10013 Phone: 212-233-6662 Fax: 212-233-6663 | |
Debra Green, Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 E 57th St, Suite 510, New York, NY 10022 Phone: 212-584-5402 Fax: 212-744-4072 | |
S. Nadesan Physician, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308a East 15th Street, New York, NY 10003 Phone: 212-420-6460 Fax: 646-602-1091 | |
Avraham Y Henoch Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 564 W 160th St, New York, NY 10032 Phone: 212-740-6400 Fax: 212-740-4105 | |
Vincent Esposito Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 W 86th St, Ste 1a, New York, NY 10024 Phone: 212-595-1234 Fax: 212-595-0342 | |
Jeffrey Glick Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 E 65th St, New York, NY 10065 Phone: 212-861-4278 | |
Columbiadoctors Ambulatory Care Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 630 W 168th St, Bb 2-239, New York, NY 10032 Phone: 212-305-1181 |