Provider Demographics
NPI:1376370189
Name:CENTER COMPREHENSIVE HEALTH PRACTICE
Entity type:Organization
Organization Name:CENTER COMPREHENSIVE HEALTH PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEER SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:OQUENDO
Authorized Official - Suffix:
Authorized Official - Credentials:CRPA
Authorized Official - Phone:347-805-1804
Mailing Address - Street 1:35 E 110TH ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-0354
Mailing Address - Country:US
Mailing Address - Phone:212-360-7700
Mailing Address - Fax:
Practice Address - Street 1:35 E 110TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-0354
Practice Address - Country:US
Practice Address - Phone:212-360-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder