NPI | 1013360528 |
---|---|
Doing Business As | RYAN FREDERICK DOUGLASS COMMUNITY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | JOSE VIRELLA Chief Financial Officer 212-316-7906 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NY 7002243R) |
Enumeration Date | 2016-07-20 |
Last Update Date | 2024-07-15 |