BOYS CLUB OF NEW YORK , NPI 1760441489 — THE BOYS CLUB OF NEW YORK in NEW YORK (NY)

NPI 1760441489

14+ Years Experience Organization

BOYS CLUB OF NEW YORK

Other organization name: THE BOYS CLUB OF NEW YORK. Name type code: 4 - former legal business name.

03/21/2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1760441489
NPI NUMBER

About BOYS CLUB OF NEW YORK

BOYS CLUB OF NEW YORK is a provider established in NEW YORK, NY. The NPI number of BOYS CLUB OF NEW YORK is 1760441489 and was assigned on 03/21/2006. The practitioners primary taxonomy code is: 261Q00000X NY .

Mailing address

  • City: NEW YORK
  • State: NY
  • Postal code: 100094816
  • Phone: 2125332554
  • Fax: 2123530016
  • Address: 287 E 10TH ST

Primary Practice Address

  • Region : NEW YORK, NY
  • NPI : 1760441489
  • Phone : 2125332554
  • Fax : 2123530016
  • Postalcode : 100094816
  • Address : 287 E 10TH ST

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261Q00000X
  • License state: NY

The primary taxonomy switch is Not Answered.

Taxonomy description: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Healthcare provider taxonomy #2 - Clinic/Center

  • Taxonomy code: 261QD0000X
  • License state: NY

The primary taxonomy switch is Not Answered.

Contacts:

Click to Show Map
  • BOYS CLUB OF NEW YORK
  • Address : 287 E 10TH ST
  • Region : NEW YORK, NY
  • NPI : 1760441489
  • Phone : 2125332554
  • Fax : 2123530016
  • Postalcode : 100094816

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 2125332554
  • Title or position : EXECUTIVE DIRECTOR

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

Field Name Value
Provider First Line Business Practice Location Address287 E 10TH 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 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 Code100094816
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 Number2125332554
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2123530016
The fax number associated with the location address of the provider being identified.
NPI1760441489
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261Q00000X
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Provider Enumeration Date03/21/2006
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)BOYS CLUB OF NEW YORK
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 Other Organization NameTHE BOYS CLUB OF NEW YORK
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code4
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address287 E 10TH 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 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 Code100094816
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 Number2125332554
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 Number2123530016
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 NameZERVAS
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 NameBRAD
The first name of the authorized official
Authorized Official Title or PositionEXECUTIVE DIRECTOR
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Telephone Number2125332554
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261Q00000X
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
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1X
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.
Healthcare Provider Taxonomy Code 2261QD0000X
Healthcare Provider Taxonomy 2Clinic/Center
Provider License Number State Code 2NY
Healthcare Provider Primary Taxonomy Switch 2X
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

Share this page?