NPIMap

Organization Active NPI

Nycdohmh East Harlem DHC

  • Community Health Clinic/Center
  • New York, NY
National Provider Identifier
1790705085
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
7002112R1535 Issued in NY
Legal business name
NYCDOHMH EAST HARLEM DHC
Practice address
258 East 115TH Street
New York, NY 10029-2031
Phone
(212) 360-5939
Fax
(212) 876-0338
NPI assigned
Jul 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Micahel James Smook, MASTERS IN PUBLIC AD
Title
Administrator Manager Third Party
Phone
(212) 232-2423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 7002112R1535 NY Primary

Addresses

Primary practice location

258 East 115TH Street
New York, NY 10029-2031

Mailing address

125 Worth Street
Box 74 RM 901
New York, NY 10013-4006
Phone (212) 442-8468

Other identifiers 1

IdentifierTypeStateIssuer
00247645MedicaidNY

Other names 1

  • NYC Dept of Health and Mental Health Hygiene's East Harlem Dist Other name

National Provider Directory

National Provider Directory
Tax ID family
New York City Dept of H46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790705085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WORTH STREET",
            "address_2": "BOX 74 RM 901",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134006",
            "telephone_number": "212-442-8468",
            "fax_number": "212-442-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 EAST 115TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100292031",
            "telephone_number": "212-360-5939",
            "fax_number": "212-876-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYCDOHMH EAST HARLEM DHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMOOK",
        "authorized_official_first_name": "MICAHEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATOR MANAGER THIRD PARTY",
        "authorized_official_telephone_number": "212-232-2423",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTERS IN PUBLIC AD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NY",
            "license": "7002112R1535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00247645",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYC Dept of Health and Mental Health Hygiene's East Harlem Dist",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.