Provider Demographics
NPI:1679787998
Name:INTERFAITH MEDICAL CENTER
Entity Type:Organization
Organization Name:INTERFAITH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SALAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-613-4784
Mailing Address - Street 1:20 BAY STREET LNDG APT 3L
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2536
Mailing Address - Country:US
Mailing Address - Phone:718-816-9648
Mailing Address - Fax:
Practice Address - Street 1:INTERFAITH MEDICAL CENTER
Practice Address - Street 2:1545 ATLANTIC AVE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213
Practice Address - Country:US
Practice Address - Phone:718-613-4784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital