| Project Renewal Inc | |
|
4380 Bronx Blvd Bronx NY 10466-1318 | |
| (718) 414-1777 | |
| (718) 231-7235 |
| Full Name | Project Renewal Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4380 Bronx Blvd, Bronx, New York |
| Authorized Official Name and Position | Steven Jones (CFO) |
| Authorized Official Contact | 2126200340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Project Renewal Inc 200 Varick St Fl 9 New York NY 10014-4810 Ph: (212) 620-0340 | Project Renewal Inc 4380 Bronx Blvd Bronx NY 10466-1318 Ph: (718) 414-1777 |
| NPI Number | 1821740275 |
|---|---|
| Provider Enumeration Date | 01/26/2022 |
| Last Update Date | 02/17/2022 |
| Medicare PECOS PAC ID | 6901798651 |
|---|---|
| Medicare Enrollment ID | O20210816003513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821740275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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