Provider Demographics
NPI:1174067367
Name:INTERNATIONAL CENTER OF HOPE
Entity type:Organization
Organization Name:INTERNATIONAL CENTER OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WHITCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-787-8315
Mailing Address - Street 1:101 W 116TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2521
Mailing Address - Country:US
Mailing Address - Phone:212-787-8315
Mailing Address - Fax:212-787-1740
Practice Address - Street 1:101 W 116TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2521
Practice Address - Country:US
Practice Address - Phone:212-787-8315
Practice Address - Fax:212-787-1740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty