BEACON CHRISTIAN COMMUNITY HEALTH CENTER INC (NPI# 1750700902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750700902 |
| Entity Type | Organization |
| Organization Name | BEACON CHRISTIAN COMMUNITY HEALTH CENTER INC |
| Practice Address |
2031 Forest Ave Staten Island NY 10303-1733 |
| Mailing Address |
2079 Forest Ave Staten Island NY 10303-1865 |
| Practice Telephone | 7188156560 |
| Practice Fax Number | 7188156576 |
| Mailing Telephone | 7188156560 |
| Mailing Fax Number | 7188156576 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2016-06-27 |
| Authorized Official Name | DR. DAVID H KIM (CEO) |
| Authorized Official Telephone | 7188156560 |
| Authorized Official Credential | MD, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Street Address |
2031 FOREST AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10303-1733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114580297 | Krisiya Ilianna Deschamps-perez | Registered Nurse | 12 Kinsey Pl, Staten Island, NY 10303 | 2019-04-15 |
| 1376057398 | Vine Gate Inc. | Case Management | 42 Amity Pl, Staten Island, NY 10303 | 2017-11-29 |
| 1396289815 | Lateefat Onitiri | Licensed Practical Nurse | 21 Wright Avenue, Staten Island, NY 10303 | 2016-12-19 |
| 1922466101 | Lydia Ogaja | Registered Nurse | 176 B Netherland Avenue, Staten Island, NY 10303 | 2016-02-03 |
| 1679994594 | Sibi Abraham | Physical Therapist | 2324 Forest Ave Ny, Staten Island, NY 10303 | 2013-12-18 |
| 1750633442 | Geraldine Gamboa | Physical Therapist | 939 Goethals Road North, Unit 1, Staten Island, NY 10303 | 2012-10-05 |
| 1710235635 | Michael J. Tighe | Specialist | 400 Lake Avenue, Visiting Nurse Association, Staten Island, NY 10303 | 2012-08-27 |
| 1710232798 | Funmilola Azeezat Kolawole | Licensed Practical Nurse | 85 Lockman Av, Staten Island, NY 10303 | 2012-07-17 |
| 1396013520 | Destiny Rodriguez | Interpreter | 35 Holland Ave. Apt. 8c, Staten Island, NY 10303 | 2011-12-02 |
| 1497043756 | Margaret Ultra Home Care Inc. | Licensed Practical Nurse | 271b Maple Parkway, Staten Island, NY 10303 | 2011-07-20 |
| Find all providers in zip 10303 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1952739054 | Community Health Center of Richmond Inc | Clinic/Center | 439 Port Richmond Ave, Staten Island, NY 10302-1714 | 2013-10-29 |
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| 1962040246 | Community Health Project Inc. | Clinic/Center | 40 Flatbush Avenue Extension, Brooklyn, NY 11201 | 2019-12-17 |
| 1245886753 | Care for The Homeless | Clinic/Center | 91 Junius St, Brooklyn, NY 11212-8021 | 2019-08-12 |
| 1184186496 | Oda Primary Health Care Network, Inc. | Clinic/Center | 74 Wallabout Street, Brooklyn, NY 11249 | 2019-04-04 |
| 1538621289 | Ezras Choilim Health Center, Inc. | Clinic/Center | 49 Forest Rd Fl 3, Monroe, NY 10950-2923 | 2019-04-02 |
| 1134693708 | Rochester Primary Care Network, Inc | Clinic/Center | 3 Parkside Ct Bldg 1, Utica, NY 13501-5643 | 2019-01-17 |
| 1164994190 | Morris Heights Health Center, Inc. | Clinic/Center | 1 W Burnside Ave, Bronx, NY 10453-4003 | 2019-01-02 |
| Find all providers with the same taxonomy | ||||
| City | STATEN ISLAND |
| Zip Code | 10303 |
Please comment or provide details below to improve the information on BEACON CHRISTIAN COMMUNITY HEALTH CENTER INC.
| 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.