| Open Door Family Medical Center Inc | |
|
5 Grace Church St Port Chester NY 10573-4911 | |
| (914) 937-8899 | |
| (914) 933-2740 |
| Full Name | Open Door Family Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5 Grace Church St, Port Chester, 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) 502-1470 | Open Door Family Medical Center Inc 5 Grace Church St Port Chester NY 10573-4911 Ph: (914) 937-8899 |
| NPI Number | 1285893719 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 06/09/2008 |
| Medicare PECOS PAC ID | 7113835380 |
|---|---|
| Medicare Enrollment ID | O20021205000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285893719 | NPI | - | NPPES |
| 00473029 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 5905200R (New York) | Primary |
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