INTERFAITH MEDICAL CENTER (NPI# 1538338702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538338702 |
| Entity Type | Organization |
| Organization Name | INTERFAITH MEDICAL CENTER |
| Practice Address |
1366 E New York Ave Brooklyn NY 11212-4535 |
| Mailing Address |
1545 Atlantic Ave Brooklyn NY 11213-1122 |
| Practice Telephone | 7186136701 |
| Practice Fax Number | 7186135725 |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2016-10-06 |
| Authorized Official Name | EMMANUEL PREMPEH (MANAGER) |
| Authorized Official Telephone | 7186137114 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02361526 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265855944 | Interfaith Medical Center | Student in an Organized Health Care Education/Training Program | 10517 77th St, Fl 2, Ozone Park, NY 11417-1010 | 2014-01-30 |
| 1508909987 | Interfaith Medical Center | General Acute Care Hospital | 500 Saint Marks Ave, Brooklyn, NY 11238-3710 | 2007-02-15 |
| 1487724712 | Interfaith Medical Center | General Acute Care Hospital | 1545 Atlantic Avenue, Brooklyn, NY 11213 | 2006-11-08 |
| 1255686184 | Interfaith Medical Center | Psychiatric Hospital | 1545 Atlantic Ave, Brooklyn, NY 11213-1122 | 2012-07-17 |
| 1790030641 | Interfaith Medical Center | Psychiatric Hospital | 1545 Atlantic Ave, Brooklyn, NY 11213-1122 | 2012-07-17 |
| 1093047821 | Interfaith Medical Center | General Acute Care Hospital | 1545 Atlantic Ave, Brooklyn, NY 11213-1122 | 2010-02-04 |
| 1235387309 | Interfaith Medical Center | Clinic/Center | 1475 Fulton St, Brooklyn, NY 11216-2506 | 2008-09-03 |
| 1588868889 | Interfaith Medical Center | Psychiatric Unit | 1545 Atlantic Ave, Brooklyn, NY 11213-1122 | 2007-06-12 |
| 1669674016 | Interfaith Medical Center | Psychiatric Unit | 1545 Atlantic Ave, Brooklyn, NY 11213-1122 | 2007-06-05 |
| 1801007893 | Interfaith Medical Center | General Acute Care Hospital | 1545 Atlantic Ave, Brooklyn, NY 11213-1122 | 2007-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INTERFAITH MEDICAL CENTER | 1545 Atlantic Ave, Brooklyn, NY 11213-1122 |
| Street Address |
1366 E NEW YORK AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11212-4535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396365136 | Ama Asabea Asare | Student in an Organized Health Care Education/Training Program | Emergency Medicine, Brookdale University Hospital and M, 1 Brookdale Plaza, Brooklyn, NY 11212 | 2020-04-22 |
| 1811516560 | Amrusha Musunuru | Student in an Organized Health Care Education/Training Program | Room 222 Chc, Department of Surgical Services, The Broo, Brookdale, NY 11212 | 2020-04-13 |
| 1508414707 | Sri Lakshmi Atthota | Student in an Organized Health Care Education/Training Program | Brookdale University Hospital,room 222, Chc, One Brookdale Plaza, Brooklyn,new York, NY 11212 | 2019-08-30 |
| 1457812273 | Shane Devanand Naidoo | Student in an Organized Health Care Education/Training Program | Dept of Emergency Medicine, Brookdale Hospital Med Cntr, 1 Brookdale Plaza, Brooklyn, NY 11212 | 2019-03-26 |
| 1790262467 | Xiao Xiong You | Student in an Organized Health Care Education/Training Program | 1 Brookdale Plaza, Department of Adult Psychiatry, Brooklyn, NY 11212 | 2018-07-25 |
| 1215426143 | Danielle Levy | Counselor | 298 Hegeman Ave, Brooklyn, NY 11212 | 2018-05-07 |
| 1699298026 | Alexander Andreev | Student in an Organized Health Care Education/Training Program | 1 Brookdale Plaza, Brooklyn, Brooklyn, NY 11212 | 2017-07-18 |
| 1598288011 | Naga Venkata Divya Challa | Student in an Organized Health Care Education/Training Program | One Brookdale Plaza, 8 Chc Room 801-5, Department of Pediatrics, Brookdale University Hospital, Brooklyn, NY 11212 | 2017-07-18 |
| 1912428921 | Sadrac Edouard | Licensed Practical Nurse | 498 East 94th St, Brooklyn, NY 11212 | 2017-06-29 |
| 1023544194 | Orrett Layne | Licensed Practical Nurse | 279 East 92nd Street, Brooklyn, NY 11212 | 2017-05-10 |
| Find all providers in zip 11212 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508280504 | Advanced Therapeutic Solutions | Community Based Residential Treatment Facility, Mental Illness | 1731 61st St Apt 4, Brooklyn, NY 11204-2219 | 2014-02-11 |
| 1164758454 | International Center Foe The Disabled | Community Based Residential Treatment Facility, Mental Illness | 270 Jay St # 51, Brooklyn, NY 11201-1949 | 2009-10-22 |
| 1396996286 | Institute for Community Living | Community Based Residential Treatment Facility, Mental Illness | 161 Emerson Place, Brooklyn, NY 11205 | 2008-10-09 |
| 1538329487 | Jewish Board of Family and Children's Services | Community Based Residential Treatment Facility, Mental Illness | 1380 36th St, Brooklyn, NY 11218-3045 | 2008-06-13 |
| 1255521746 | Coalition for Hispanic Families | Community Based Residential Treatment Facility, Mental Illness | 315 Wyckoff Ave, Brooklyn, NY 11237-5842 | 2007-07-31 |
| 1518091271 | Brooklyn Community Housing & Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 105 Carlton Ave, Brooklyn, NY 11205-2201 | 2007-03-15 |
| 1528424629 | Lynda R Joseph | Community Based Residential Treatment Facility, Mental Illness | 1900b Ralph Ave, Brooklyn, NY 11234-5302 | 2016-01-06 |
| 1346491230 | Institute for Community Living | Community Based Residential Treatment Facility, Mental Illness | 161 Emerson Place, Brooklyn, NY 11205 | 2008-10-09 |
| 1366646291 | Catholic Charities Neighborhood Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 191 Joralemon St, Brooklyn, NY 11201-4306 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922661784 | Greater Horizons, House Inc. | Community Based Residential Treatment Facility, Mental Illness | 25 Indian Rd Apt 6f, New York, NY 10034-1018 | 2019-04-17 |
| 1013474113 | Hope House On Crotona Park, LLC | Community Based Residential Treatment Facility, Mental Illness | 853 Crotona Park N, Bronx, NY 10460-4701 | 2019-02-25 |
| 1457825135 | Eating Disorder Treatment of New York, LLC | Community Based Residential Treatment Facility, Mental Illness | 1 Saint Andrews Ln, Glen Cove, NY 11542-2221 | 2019-01-16 |
| 1679011530 | Nando Pelusi, Phd | Community Based Residential Treatment Facility, Mental Illness | 305 Hicks Street, 2, Brookyn, NY 11201 | 2017-02-10 |
| 1245684729 | William F Ryan Community Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 138 W 143rd St, New York, NY 10030-1615 | 2016-04-20 |
| 1205280955 | William F Ryan Community Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 22 Convent Ave, New York, NY 10027-2604 | 2016-04-19 |
| 1245602838 | Nyeshia Skipwith | Community Based Residential Treatment Facility, Mental Illness | 37 Titmus Dr, Mastic, NY 11950-2011 | 2015-10-22 |
| 1447663067 | 187 Cottage Avenue Corp | Community Based Residential Treatment Facility, Mental Illness | 187 Cottage Ave, Mount Vernon, NY 10550-1446 | 2014-06-11 |
| 1235542135 | Erin Faryna | Community Based Residential Treatment Facility, Mental Illness | 51 Rossler Ave, Cheektowaga, NY 14206-2409 | 2014-06-09 |
| 1194163147 | Areivim | Community Based Residential Treatment Facility, Mental Illness | 20 Briarcliff Dr, Monsey, NY 10952 | 2013-06-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.