Provider Demographics
NPI:1154951549
Name:NEW YORK FOUNDLING
Entity type:Organization
Organization Name:NEW YORK FOUNDLING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOJICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-485-7291
Mailing Address - Street 1:590 AVENUE OF AMERICAS
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:917-485-7291
Mailing Address - Fax:
Practice Address - Street 1:163 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-5579
Practice Address - Country:US
Practice Address - Phone:718-965-1998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities