| Samaritan Daytop Village, Inc. | |
|
368 E 148th St Bronx NY 10455-4005 | |
| (718) 402-2614 | |
| (718) 402-5017 |
| Full Name | Samaritan Daytop Village, Inc. |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 368 E 148th St, Bronx, New York |
| Authorized Official Name and Position | Charles Madray (VP OF HEALTH SERVICES & COMM BASED) |
| Authorized Official Contact | 7182062000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Daytop Village, Inc. 138-02 Queens Blvd Briarwood NY 11435 Ph: () - | Samaritan Daytop Village, Inc. 368 E 148th St Bronx NY 10455-4005 Ph: (718) 402-2614 |
| NPI Number | 1245272772 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 04/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245272772 | NPI | - | NPPES |
| 012222191 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 132690403 (New York) | Primary |
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