Provider Demographics
NPI:1700263175
Name:NEW YORK CENTER FOR ADDICTION TREATMENT SERVICES, INC.
Entity Type:Organization
Organization Name:NEW YORK CENTER FOR ADDICTION TREATMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EVERETT
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-882-9652
Mailing Address - Street 1:598 BROADWAY FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3363
Mailing Address - Country:US
Mailing Address - Phone:212-966-9537
Mailing Address - Fax:212-584-5450
Practice Address - Street 1:3720 74TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6338
Practice Address - Country:US
Practice Address - Phone:718-426-6222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK CENTER FOR ADDICTION TREATMENT SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-05
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160411881261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY160411881OtherOASAS