Provider Demographics
NPI:1194861179
Name:LINCOLN MEDICAL MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:LINCOLN MEDICAL MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC RESIDENT LEVEL IV
Authorized Official - Prefix:DR
Authorized Official - First Name:SOCRATES
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:718-579-5000
Mailing Address - Street 1:234 E 149TH ST 10-C
Mailing Address - Street 2:BRONX NEW YORK
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-579-5000
Mailing Address - Fax:718-579-5284
Practice Address - Street 1:234 E 149TH ST 10-C
Practice Address - Street 2:BRONX NEW YORK
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-5000
Practice Address - Fax:718-579-5284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital