Provider Demographics
NPI:1609996396
Name:NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Entity Type:Organization
Organization Name:NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Other - Org Name:JACOBI MEDICAL CENTER ASSERTIVE COMMUNITY TREATMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSITANT VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-458-3402
Mailing Address - Street 1:160 WATER ST
Mailing Address - Street 2:ROOM 736
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4922
Mailing Address - Country:US
Mailing Address - Phone:646-458-3402
Mailing Address - Fax:646-458-3434
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-3287
Practice Address - Fax:718-918-7113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02996523Medicaid
NY02717540Medicaid
NY02660231Medicaid