Provider Demographics
NPI:1699934984
Name:FORT WASHINGTON CENTER LLP
Entity type:Organization
Organization Name:FORT WASHINGTON CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-543-1700
Mailing Address - Street 1:130 FORT WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4724
Mailing Address - Country:US
Mailing Address - Phone:212-543-1700
Mailing Address - Fax:212-543-1707
Practice Address - Street 1:130 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4724
Practice Address - Country:US
Practice Address - Phone:212-543-1700
Practice Address - Fax:212-543-1707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical