Organization · Type 2 NPI

Sun River Health Inc

Federally Qualified Health Center (FQHC) · Staten Island, NY

NPI number 1174006803 Active

Practice location

57 Bay Street, Bay Street Health Center
Staten Island, NY 10301-2510

Call (855) 681-8700 Map

Fax (718) 442-1521

Mailing address

PO Box 5036
White Plains, NY 10602-5036

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	5901200R (NY)

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Benito Joseph Jr., PMHNP-BCPsychiatric/Mental Health Nurse Practitioner Staten Island, NY NPI 1003671850

Other federally qualified health center (fqhc) providers in Staten Island

See all in Staten Island →

NPI record

NPI: 1174006803
Entity type: Organization (Type 2)
Issued: Sep 10, 2018
Last updated: Mar 14, 2022
Status: Active
Subpart: Yes of Sun River Health Inc

Other names

<unavail>
Bay Street Health Center · other name
Bay Street Health Center · other name

Authorized official

Adam K. Lipton
VP Info/practice MGMT Systems
(914) 384-2375

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174006803

Sun River Health Inc's National Provider Identifier is 1174006803, issued on Sep 10, 2018. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Staten Island, NY. The record was last updated on Mar 14, 2022.