SOHO COMMUNITY CLINIC , NPI 1174563548 — NEW YORK (NY)

NPI 1174563548

13+ Years Experience Organization

SOHO COMMUNITY CLINIC

06.07.2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1174563548
NPI NUMBER

About SOHO COMMUNITY CLINIC

SOHO COMMUNITY CLINIC is a provider established in NEW YORK, NY. The NPI number of SOHO COMMUNITY CLINIC is 1174563548 and was assigned on 06.07.2006. The practitioners primary taxonomy code is: 261QV0200X .

Mailing address

  • City: NEW YORK
  • State: NY
  • Postal code: 100144805
  • Phone: 2123372569
  • Fax: 2123372537
  • Address: 245 W HOUSTON ST
  • Address 2: ROOM 313

Primary Practice Address

  • Region : NEW YORK, NY
  • NPI : 1174563548
  • Phone : 2123372569
  • Fax : 2123372537
  • Postalcode : 100144805
  • Address : 245 W HOUSTON ST ROOM 313

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QV0200X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • SOHO COMMUNITY CLINIC
  • Address : 245 W HOUSTON ST ROOM 313
  • Region : NEW YORK, NY
  • NPI : 1174563548
  • Phone : 2123372569
  • Fax : 2123372537
  • Postalcode : 100144805

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 2022540339
  • Title or position : DIRECTOR, BUSINESS DEVELOPMENT

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address245 W HOUSTON ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressROOM 313
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNEW YORK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code100144805
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2123372569
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2123372537
The fax number associated with the location address of the provider being identified.
NPI1174563548
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QV0200X
Provider Enumeration Date06.07.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)SOHO COMMUNITY CLINIC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address245 W HOUSTON ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressROOM 313
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameNEW YORK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code100144805
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2123372569
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number2123372537
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameMAYERICK
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameBARBARA
The first name of the authorized official
Authorized Official Title or PositionDIRECTOR, BUSINESS DEVELOPMENT
The title or position of the authorized official
Authorized Official Telephone Number2022540339
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QV0200X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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