Provider Demographics
NPI:1548998347
Name:NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Entity type:Organization
Organization Name:NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:LUCHY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-238-7815
Mailing Address - Street 1:1920 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-4249
Mailing Address - Country:US
Mailing Address - Phone:646-815-9700
Mailing Address - Fax:646-815-9571
Practice Address - Street 1:TREMONT COMMUNITY HEALTH CENTER OF EXCELLENCE
Practice Address - Street 2:1920 WEBSTER AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4249
Practice Address - Country:US
Practice Address - Phone:646-815-9700
Practice Address - Fax:646-815-9571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty