Provider Demographics
| NPI: | 1295729408 |
|---|---|
| Name: | THE INSTITUTE FOR FAMILY HEALTH |
| Entity type: | Organization |
| Organization Name: | THE INSTITUTE FOR FAMILY HEALTH |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT AND CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ERIC |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | GAYLE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 212-633-0800 |
| Mailing Address - Street 1: | TD |
| Mailing Address - Street 2: | CL#4655 PO BOX 95000 |
| Mailing Address - City: | PHILADELPHIA |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 19195-4655 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 845-255-3766 |
| Mailing Address - Fax: | 845-255-3753 |
| Practice Address - Street 1: | 16 E 16TH ST |
| Practice Address - Street 2: | |
| Practice Address - City: | NEW YORK |
| Practice Address - State: | NY |
| Practice Address - Zip Code: | 10003-3105 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 212-633-0800 |
| Practice Address - Fax: | 212-691-4610 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-09-01 |
| Last Update Date: | 2025-04-22 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 1041C0700X, 207Q00000X | ||
| NY | 127500 | 332900000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 332900000X | Suppliers | Non-Pharmacy Dispensing Site | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| 3350612 | Other | OTHER ID NUMBER | |
| NY | 00903700 | Medicaid | |
| NY | 331014 | Medicare Oscar/Certification | |
| NY | 331056 | Medicare Oscar/Certification | |
| 331962 | Medicare Oscar/Certification | ||
| 331913 | Medicare Oscar/Certification | ||
| 331959 | Medicare Oscar/Certification | ||
| 331965 | Medicare Oscar/Certification | ||
| 331966 | Medicare Oscar/Certification | ||
| NY | 331012 | Medicare Oscar/Certification | |
| 331914 | Medicare Oscar/Certification | ||
| 331960 | Medicare Oscar/Certification | ||
| 331963 | Medicare Oscar/Certification | ||
| 331915 | Medicare Oscar/Certification | ||
| 331912 | Medicare Oscar/Certification | ||
| 331961 | Medicare Oscar/Certification | ||
| 331964 | Medicare Oscar/Certification | ||
| 3350612 | Other | OTHER ID NUMBER | |
| NY | 00903700 | Medicaid | |
| 331910 | Medicare Oscar/Certification | ||
| 331911 | Medicare Oscar/Certification | ||
| 331963 | Medicare Oscar/Certification |
