Provider Demographics
NPI:1003007766
Name:PUBLIC HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:PUBLIC HEALTH SOLUTIONS
Other - Org Name:PUBLIC HEALTH SOLUTIONS -SRHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-619-6400
Mailing Address - Street 1:40 WORTH ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2904
Mailing Address - Country:US
Mailing Address - Phone:646-619-6400
Mailing Address - Fax:
Practice Address - Street 1:295 FLATBUSH AVENUE EXT FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3001
Practice Address - Country:US
Practice Address - Phone:718-522-1144
Practice Address - Fax:646-619-6696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PUBLIC HEALTH SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-07
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 252Y00000X
NY7002296R261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00245538Medicaid