Provider Demographics
NPI:1639259336
Name:SENIOR CITIZENS CARE GROUP,LLP
Entity Type:Organization
Organization Name:SENIOR CITIZENS CARE GROUP,LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:800-611-3700
Mailing Address - Street 1:141 E 55TH ST
Mailing Address - Street 2:2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4030
Mailing Address - Country:US
Mailing Address - Phone:800-611-3700
Mailing Address - Fax:212-750-6350
Practice Address - Street 1:141 E 55TH ST
Practice Address - Street 2:2A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4030
Practice Address - Country:US
Practice Address - Phone:800-611-3700
Practice Address - Fax:212-750-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01741524Medicaid
NYV0W451Medicare ID - Type Unspecified
NY01741524Medicaid