Provider Demographics
NPI:1528232923
Name:TRI CENTER - BRONX
Entity Type:Organization
Organization Name:TRI CENTER - BRONX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBORAH MANNERS-GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CASAC
Authorized Official - Phone:718-584-7204
Mailing Address - Street 1:2488 GRAND CONCOURSE
Mailing Address - Street 2:STE 417
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5203
Mailing Address - Country:US
Mailing Address - Phone:718-584-7204
Mailing Address - Fax:718-584-8395
Practice Address - Street 1:2488 GRAND CONCOURSE
Practice Address - Street 2:STE 417
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5203
Practice Address - Country:US
Practice Address - Phone:718-584-7204
Practice Address - Fax:718-584-8395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080711466261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)