| 820 River Street | |
|
10830 Sutphin Blvd Jamaica NY 11435-5444 | |
| (718) 526-3803 | |
| (718) 526-3908 |
| Full Name | 820 River Street |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 10830 Sutphin Blvd, Jamaica, New York |
| Authorized Official Name and Position | Elizabeth Vasquez (OFICE MANAGER) |
| Authorized Official Contact | 7185263803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 820 River Street 10830 Sutphin Blvd Jamaica NY 11435-5444 Ph: (718) 526-3803 | 820 River Street 10830 Sutphin Blvd Jamaica NY 11435-5444 Ph: (718) 526-3803 |
| NPI Number | 1588077655 |
|---|---|
| Provider Enumeration Date | 06/06/2014 |
| Last Update Date | 06/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588077655 | NPI | - | NPPES |
| 01137159 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New York) | Primary |
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