Provider Demographics
NPI:1609275205
Name:ODA PRIMARY HEALTH CARE NETWORK, INC.
Entity Type:Organization
Organization Name:ODA PRIMARY HEALTH CARE NETWORK, INC.
Other - Org Name:ODA QUALITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEUTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-260-4600
Mailing Address - Street 1:14 HEYWARD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-7823
Mailing Address - Country:US
Mailing Address - Phone:718-260-4600
Mailing Address - Fax:718-852-0867
Practice Address - Street 1:432 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-6588
Practice Address - Country:US
Practice Address - Phone:718-387-2408
Practice Address - Fax:718-387-9222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ODA PRIMARY HEALTH CARE NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-19
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7001254R261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care