Basic Information
| Provider Information | |||||||||
| NPI: | 1649346222 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | ||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | HARLEM HOSPITAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | HARLEM HOSPITAL CENTER C/O OUTPATIENT PHARMACY | ||||||||
| Address2: | 46 WEST 137TH STREET | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129391761 | ||||||||
| FaxNumber: | 2129391759 | ||||||||
| Practice Location | |||||||||
| Address1: | HARLEM HOSPITAL CENTER C/O OUTPATIENT PHARMACY | ||||||||
| Address2: | 46 WEST 137TH STREET | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129391761 | ||||||||
| FaxNumber: | 2129391759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2006 | ||||||||
| LastUpdateDate: | 12/16/2019 | ||||||||
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| AuthorizedOfficialLastName: | FAROOQI | ||||||||
| AuthorizedOfficialFirstName: | HINNAH | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | ASSOCIATE EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2129391761 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 12/16/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 006494 | NY | N | Hospitals | General Acute Care Hospital | Critical Access | 333600000X | N | Suppliers | Pharmacy | 333600000X | 028985 | NY | Y | Suppliers | Pharmacy |
ID Information
| ID | Type | State | Issuer | Description | 05525764 | 05 | NY | MEDICAID | 00246108 | 05 | NY | MEDICAID |