Basic Information
| Provider Information | |||||||||
| NPI: | 1538547476 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. ANN'S CORNER OF HARM REDUCTION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 886 WESTCHESTER AVE | ||||||||
| Address2: | GROUND FLOOR SUITE | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104594010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185855544 | ||||||||
| FaxNumber: | 7185858314 | ||||||||
| Practice Location | |||||||||
| Address1: | 886 WESTCHESTER AVE | ||||||||
| Address2: | GROUND FLOOR SUITE | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104594010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185855544 | ||||||||
| FaxNumber: | 7185858314 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2015 | ||||||||
| LastUpdateDate: | 05/12/2015 | ||||||||
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| AuthorizedOfficialLastName: | MAJOOR | ||||||||
| AuthorizedOfficialFirstName: | LAMBERTUS | ||||||||
| AuthorizedOfficialMiddleName: | BART | ||||||||
| AuthorizedOfficialTitleorPosition: | DEPUTY & CLINICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7185855544 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.