PHOENIX HOUSE FOUNDATION INC. NPI 1639247653

NPI Information

NPI: 1639247653
Provider Name: PHOENIX HOUSE FOUNDATION, INC.
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
164 W 74TH ST
NEW YORK, NY
ZIP 10023
Phone: (718) 222-6600
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PHOENIX HOUSE FOUNDATION, INC. is a multi-specialty clinic center in New York, NY. PHOENIX HOUSE FOUNDATION, INC. NPI is 1639247653. The provider is registered as an organization entity type.

The provider's business location address is:

164 W 74TH ST
NEW YORK, NY
ZIP 10023-301
Phone: (718) 222-6600
Fax: (718) 576-2866

The provider's authorized official is Kevin Kirchoff .
The authorized official title is Sr. Vice President, Cfo and has the following contact phone number (212) 595-5810.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	7002298R	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00371673	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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