Provider Demographics
NPI:1790803328
Name:CITICARE INC
Entity Type:Organization
Organization Name:CITICARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SILVA
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:UMUKORO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:212-749-3508
Mailing Address - Street 1:159 W 127TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3723
Mailing Address - Country:US
Mailing Address - Phone:212-749-3507
Mailing Address - Fax:212-666-1679
Practice Address - Street 1:159 W 127TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-3723
Practice Address - Country:US
Practice Address - Phone:212-749-3507
Practice Address - Fax:212-666-1679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002299R261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health