Provider Demographics
NPI:1578115226
Name:DOMINICAN WOMEN'S DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:DOMINICAN WOMEN'S DEVELOPMENT CENTER
Other - Org Name:DWDC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSITA
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:212-994-6060
Mailing Address - Street 1:519 W 189TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-4647
Mailing Address - Country:US
Mailing Address - Phone:212-994-6060
Mailing Address - Fax:212-994-6065
Practice Address - Street 1:715 WEST 179TH STREET
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033
Practice Address - Country:US
Practice Address - Phone:212-740-4335
Practice Address - Fax:212-994-6065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health