NPIMap

Organization Active NPI

Samaritan Daytop Village, Inc.

  • Community Health Clinic/Center
  • Bronx, NY
National Provider Identifier
1245272772
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
132690403 Issued in NY
Legal business name
SAMARITAN DAYTOP VILLAGE, INC.
Practice address
368 E 148TH St
Bronx, NY 10455-4005
Phone
(718) 402-2614
Fax
(718) 402-5017
NPI assigned
Jun 11, 2006
Last updated
Apr 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles Madray
Title
VP of Health Services & Comm Based
Phone
(718) 206-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 132690403 NY Primary

Addresses

Primary practice location

368 E 148TH St
Bronx, NY 10455-4005

Mailing address

138-02 Queens Blvd
Briarwood, NY 11435

Other identifiers 1

IdentifierTypeStateIssuer
012222191MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Samaritan Village Harlem Outpatient21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1245272772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138-02 QUEENS BLVD",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "11435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 E 148TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554005",
            "telephone_number": "718-402-2614",
            "fax_number": "718-402-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN DAYTOP VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "MADRAY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "VP OF HEALTH SERVICES & COMM BASED",
        "authorized_official_telephone_number": "718-206-2000"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NY",
            "license": "132690403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012222191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.