Basic Information
| Provider Information | |||||||||
| NPI: | 1699827345 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REALIZATION CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 UNION SQ W | ||||||||
| Address2: | 7TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100033304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126279600 | ||||||||
| FaxNumber: | 2126274040 | ||||||||
| Practice Location | |||||||||
| Address1: | 19 UNION SQ W | ||||||||
| Address2: | 7TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100033304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126279600 | ||||||||
| FaxNumber: | 2126274040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SCHWARTZ | ||||||||
| AuthorizedOfficialFirstName: | DIANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2126279600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | CASAC, CPA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | NY | Y | Ambulatory Health Care Facilities | Clinic/Center |
ID Information
| ID | Type | State | Issuer | Description | ANC210 | 01 | NY | OXFORD | OTHER | 002666 | 01 | NY | EMPIRE BCBS | OTHER | 01111302 | 05 | NY | MEDICAID |