Provider Demographics
NPI:1427361567
Name:ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
Entity Type:Organization
Organization Name:ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUBSTANCE ABUSE COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUAYO
Authorized Official - Suffix:
Authorized Official - Credentials:CASAC
Authorized Official - Phone:718-665-7500
Mailing Address - Street 1:804 E 138TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-1902
Mailing Address - Country:US
Mailing Address - Phone:718-665-7500
Mailing Address - Fax:718-664-4768
Practice Address - Street 1:804 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1902
Practice Address - Country:US
Practice Address - Phone:718-665-7500
Practice Address - Fax:718-664-4768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281P00000X281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital