| Open Door Family Medical Center, Inc. | |
|
689 Mamaroneck Ave Mamaroneck NY 10543-5910 | |
| (914) 732-0233 | |
| (914) 732-0234 |
| Full Name | Open Door Family Medical Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 689 Mamaroneck Ave, Mamaroneck, New York |
| Authorized Official Name and Position | Lindsay C Farrell (PRESIDENT AND CEO) |
| Authorized Official Contact | 9145021450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Door Family Medical Center, Inc. 165 Main St Ossining NY 10562-4702 Ph: (914) 941-1263 | Open Door Family Medical Center, Inc. 689 Mamaroneck Ave Mamaroneck NY 10543-5910 Ph: (914) 732-0233 |
| NPI Number | 1487194155 |
|---|---|
| Provider Enumeration Date | 03/01/2017 |
| Last Update Date | 04/10/2017 |
| Medicare PECOS PAC ID | 7113835380 |
|---|---|
| Medicare Enrollment ID | O20170517002407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487194155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 5905200R (New York) | Primary |
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