Open Door Family Medical Center, INC.
Clinic/Center, Federally Qualified Health Center (FQHC) in Brewster, NY. Organization (NPI-2).
NPI number1003152240
StatusActive
Last updated in NPPESDec 17, 2012
Details
- NPI
- 1003152240
- Entity type
- Organization (NPI-2)
- Legal business name
- Open Door Family Medical Center, INC.
- Organization subpart
- Yes
- Enumeration date
- Dec 17, 2012
- Last updated
- Dec 17, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | 5905200R | NY | Yes |
Practice location
155 Main StBrewster, NY 10509-1521
Phone 845-279-6999 · Fax 845-279-0908
Mailing address
165 Main StOssining, NY 10562-4702
Phone 914-502-1470 · Fax 914-762-7224
Authorized official
Maria Mazzotta
Chief Finance Officer
9145021470
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