Provider Demographics
NPI:1831269273
Name:BETANCES HEALTH CENTER
Entity type:Organization
Organization Name:BETANCES HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-227-8401
Mailing Address - Street 1:280 HENRY ST
Mailing Address - Street 2:BETANCES HEALTH CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4816
Mailing Address - Country:US
Mailing Address - Phone:212-227-8401
Mailing Address - Fax:212-227-8842
Practice Address - Street 1:280 HENRY ST
Practice Address - Street 2:BETANCES HEALTH CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4816
Practice Address - Country:US
Practice Address - Phone:212-227-8401
Practice Address - Fax:212-227-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY575563163W00000X
NYF304500363LA2200X
NYF420815363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00243045Medicaid
NYW04161Medicare ID - Type UnspecifiedFACILITY NUMBER