Basic Information
| Provider Information | |||||||||
| NPI: | 1225281561 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRI CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1369 BROADWAY | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100187200 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2488 GRAND CONCOURSE | ||||||||
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| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104585203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185847204 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2008 | ||||||||
| LastUpdateDate: | 10/30/2008 | ||||||||
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| AuthorizedOfficialLastName: | GONZALEZ | ||||||||
| AuthorizedOfficialFirstName: | JOE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2122688830 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | NY | Y | Agencies | Case Management |
No ID Information.