Provider Demographics
NPI:1548676802
Name:EDIFY COMMUNITIES OF NEW YORK
Entity type:Organization
Organization Name:EDIFY COMMUNITIES OF NEW YORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:347-623-4460
Mailing Address - Street 1:859 HENDRIX ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-7901
Mailing Address - Country:US
Mailing Address - Phone:718-257-1300
Mailing Address - Fax:718-257-8767
Practice Address - Street 1:859 HENDRIX ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-7901
Practice Address - Country:US
Practice Address - Phone:718-257-1300
Practice Address - Fax:718-257-8767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management