Provider Demographics
NPI:1669642211
Name:BRONX AIDS SERVICES
Entity type:Organization
Organization Name:BRONX AIDS SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:LOWY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-401-5700
Mailing Address - Street 1:540 E FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5015
Mailing Address - Country:US
Mailing Address - Phone:718-295-5605
Mailing Address - Fax:718-733-3429
Practice Address - Street 1:760 E 160TH ST FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-7898
Practice Address - Country:US
Practice Address - Phone:718-401-5650
Practice Address - Fax:718-993-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01243521Medicaid