Provider Demographics
NPI:1598770018
Name:PROJECT RENEWAL INC
Entity Type:Organization
Organization Name:PROJECT RENEWAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL AND ADMINISTRATIVE
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-620-0340
Mailing Address - Street 1:200 VARICK ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4810
Mailing Address - Country:US
Mailing Address - Phone:212-620-0340
Mailing Address - Fax:212-633-1410
Practice Address - Street 1:8 EAST THIRD STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4810
Practice Address - Country:US
Practice Address - Phone:212-620-0340
Practice Address - Fax:212-633-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY571815OtherMEDICARE PIN
NY331103OtherMEDICARE
NY331102OtherMEDICARE
NYW32461Medicare PIN
NY01921402Medicaid