Provider Demographics
NPI:1083921837
Name:SAFE SPACE NYC
Entity Type:Organization
Organization Name:SAFE SPACE NYC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLNAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-526-2400
Mailing Address - Street 1:295 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2793
Mailing Address - Country:US
Mailing Address - Phone:718-526-2400
Mailing Address - Fax:
Practice Address - Street 1:295 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2793
Practice Address - Country:US
Practice Address - Phone:718-526-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72081755302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization