Provider Demographics
NPI:1790140044
Name:NYC DOWNTOWN HEALTH LLC
Entity Type:Organization
Organization Name:NYC DOWNTOWN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-376-6100
Mailing Address - Street 1:47 POCONO AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5433
Mailing Address - Country:US
Mailing Address - Phone:914-376-6100
Mailing Address - Fax:914-294-0420
Practice Address - Street 1:290 MADISON AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6308
Practice Address - Country:US
Practice Address - Phone:914-376-6100
Practice Address - Fax:914-294-0420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23018579207Q00000X
207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty