Provider Demographics
NPI:1215155957
Name:NYC DEPARTMENT OF HEALTH AND MENTAL
Entity type:Organization
Organization Name:NYC DEPARTMENT OF HEALTH AND MENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-396-6299
Mailing Address - Street 1:42-09 28TH STREET
Mailing Address - Street 2:17TH FLOOR, CN-48
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4132
Mailing Address - Country:US
Mailing Address - Phone:347-396-6299
Mailing Address - Fax:347-396-3667
Practice Address - Street 1:42-09 28TH STREET
Practice Address - Street 2:17TH FLOOR, CN-48
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4132
Practice Address - Country:US
Practice Address - Phone:646-527-0267
Practice Address - Fax:347-396-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01426966Medicaid