Provider Demographics
NPI:1073907481
Name:CITY OF NEW YORK, DOHMH
Entity Type:Organization
Organization Name:CITY OF NEW YORK, DOHMH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIZYAMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGHESE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:718-919-9698
Mailing Address - Street 1:515 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3028
Mailing Address - Country:US
Mailing Address - Phone:917-348-2311
Mailing Address - Fax:
Practice Address - Street 1:515 N 7TH ST
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3028
Practice Address - Country:US
Practice Address - Phone:917-348-2311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY460997314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0989701OtherDOHMH