| Community Health Action Of Staten Island, Inc. | |
|
56 Bay St Staten Island NY 10301-2563 | |
| (718) 808-1300 | |
| (718) 808-1393 |
| Full Name | Community Health Action Of Staten Island, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 56 Bay St, Staten Island, New York |
| Authorized Official Name and Position | Jennifer Lytton (SNR. VP/CHIEF FISCAL OFFICER) |
| Authorized Official Contact | 7188081422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Action Of Staten Island, Inc. 56 Bay St Staten Island NY 10301-2563 Ph: (718) 808-1300 | Community Health Action Of Staten Island, Inc. 56 Bay St Staten Island NY 10301-2563 Ph: (718) 808-1300 |
| NPI Number | 1871793356 |
|---|---|
| Provider Enumeration Date | 07/23/2007 |
| Last Update Date | 04/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871793356 | NPI | - | NPPES |
| 02521240 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 080311454 (New York) | Secondary |
| 251S00000X | Community/behavioral Health | (New York) | Primary |
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