Provider Demographics
NPI:1104215474
Name:AIDS SERVICE CENTER OF LOWER MANHATTAN
Entity Type:Organization
Organization Name:AIDS SERVICE CENTER OF LOWER MANHATTAN
Other - Org Name:ALLIED SERVICE CENTER NYC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY ED FOR PROGRAMS
Authorized Official - Prefix:
Authorized Official - First Name:ELIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-645-0875
Mailing Address - Street 1:41 E 11TH ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4602
Mailing Address - Country:US
Mailing Address - Phone:212-645-0875
Mailing Address - Fax:212-645-8711
Practice Address - Street 1:2036 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-5078
Practice Address - Country:US
Practice Address - Phone:212-645-0875
Practice Address - Fax:212-927-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151211858251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01484019Medicaid