Provider Demographics
NPI:1528230232
Name:HEARTSHARE HUMAN SERVICES OF NEW YORK
Entity Type:Organization
Organization Name:HEARTSHARE HUMAN SERVICES OF NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-422-3229
Mailing Address - Street 1:12 METROTECH CTR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:718-422-3229
Mailing Address - Fax:718-852-6339
Practice Address - Street 1:12 METROTECH CTR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-422-3229
Practice Address - Fax:718-852-6339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00848462Medicaid