Provider Demographics
NPI:1922820315
Name:AIZER HEALTH , INC.
Entity type:Organization
Organization Name:AIZER HEALTH , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MITTELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-782-3242
Mailing Address - Street 1:48 BAKERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-8428
Mailing Address - Country:US
Mailing Address - Phone:845-782-3242
Mailing Address - Fax:845-314-8076
Practice Address - Street 1:48 BAKERTOWN RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-8428
Practice Address - Country:US
Practice Address - Phone:845-782-3242
Practice Address - Fax:845-314-8076
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIZER HEALTH , INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty