Provider Demographics
NPI:1639221955
Name:HARLEM HOSPITAL CENTER
Entity Type:Organization
Organization Name:HARLEM HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:718-993-4359
Mailing Address - Street 1:711 WALTON AVE
Mailing Address - Street 2:2P
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2552
Mailing Address - Country:US
Mailing Address - Phone:718-993-4359
Mailing Address - Fax:
Practice Address - Street 1:506 MALCOLM X BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-3354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036340282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246108Medicaid
NY00246108Medicaid