Provider Demographics
NPI:1245652775
Name:NEW YORK FOUNDLING
Entity type:Organization
Organization Name:NEW YORK FOUNDLING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MULTI-SYSTEMIC THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-913-2959
Mailing Address - Street 1:590 AVE OF THE AMERICAS
Mailing Address - Street 2:27 CHRISTOPHER STREET
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2019
Mailing Address - Country:US
Mailing Address - Phone:212-660-1380
Mailing Address - Fax:
Practice Address - Street 1:590 AVE OF THE AMERICAS
Practice Address - Street 2:590 AVE OF THE AMERICAS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2019
Practice Address - Country:US
Practice Address - Phone:212-660-1380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091304-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health