Provider Demographics
NPI:1508932591
Name:EMMA L BOWEN COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:EMMA L BOWEN COMMUNITY HEALTH CENTER
Other - Org Name:UMMHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ICM
Authorized Official - Prefix:MR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:ICM
Authorized Official - Phone:212-694-3500
Mailing Address - Street 1:610 RIVERSIDE DR
Mailing Address - Street 2:#55
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031
Mailing Address - Country:US
Mailing Address - Phone:212-694-3500
Mailing Address - Fax:212-694-4998
Practice Address - Street 1:610 RIVERSIDE DR
Practice Address - Street 2:#55
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-7601
Practice Address - Country:US
Practice Address - Phone:212-694-3500
Practice Address - Fax:212-694-4998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management