| Project Hospitality, Inc. | |
|
150c Richmond Ter Staten Island NY 10301-1901 | |
| (718) 420-1475 | |
| (718) 420-1487 |
| Full Name | Project Hospitality, Inc. |
|---|---|
| Speciality | Case Management |
| Location | 150c Richmond Ter, Staten Island, New York |
| Authorized Official Name and Position | Terry Troia (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7184481544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Project Hospitality, Inc. 100 Park Ave Staten Island NY 10302-1440 Ph: (718) 448-1544 | Project Hospitality, Inc. 150c Richmond Ter Staten Island NY 10301-1901 Ph: (718) 420-1475 |
| NPI Number | 1598882284 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 06/16/2015 |
| Medicare PECOS PAC ID | 3577884097 |
|---|---|
| Medicare Enrollment ID | O20150609000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598882284 | NPI | - | NPPES |
| 01745555 | Medicaid | NY |
| Provider Name | Gale A Alwill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790851533 PECOS PAC ID: 3678535838 Enrollment ID: I20041029000777 |
| Provider Name | David Laks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093923559 PECOS PAC ID: 1658457361 Enrollment ID: I20080320000480 |
| Provider Name | Gary D Siegel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194968206 PECOS PAC ID: 4789977141 Enrollment ID: I20160721002393 |
| Provider Name | Emmanuel Ahipue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104235092 PECOS PAC ID: 1658695325 Enrollment ID: I20170329002552 |
| Provider Name | Muftau G Bello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932509767 PECOS PAC ID: 3577823194 Enrollment ID: I20180130001860 |
| Provider Name | Laura L. Novacek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780020834 PECOS PAC ID: 4183988561 Enrollment ID: I20180511000530 |
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