Provider Demographics
NPI:1114956026
Name:SENIOR HEALTH PARTNERS INC.
Entity Type:Organization
Organization Name:SENIOR HEALTH PARTNERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:POLONY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-870-5077
Mailing Address - Street 1:149 W 105TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-8803
Mailing Address - Country:US
Mailing Address - Phone:212-870-4610
Mailing Address - Fax:212-870-4731
Practice Address - Street 1:4 E 107TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3870
Practice Address - Country:US
Practice Address - Phone:212-427-2600
Practice Address - Fax:917-429-1159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02104369Medicaid
NY02104369Medicaid