Provider Demographics
NPI:1417317736
Name:DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH
Other - Org Name:CITY OF NEW YORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:914-664-1478
Mailing Address - Street 1:111 N TERRACE AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1808
Mailing Address - Country:US
Mailing Address - Phone:914-664-1478
Mailing Address - Fax:914-664-1478
Practice Address - Street 1:111 N TERRACE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-1808
Practice Address - Country:US
Practice Address - Phone:914-664-1478
Practice Address - Fax:914-664-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY484334251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care