| Organization Name: | OPEN DOOR FAMILY MEDICAL CENTER INC |
| NPI Number: | 1285893719 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDSAY C. FARRELL (PRESIDENT AND CEO) |
| Mailing Address: | 5 Grace Church St Port Chester |
| State: | NY US |
| Postal Code: | 105734911 |
| Phone Number: | 9149378899 |
| Fax Number: | 9149332740 |
| NPI Enumeration Date: | 06/09/2008 |
| NPI Last Update Date: | 06/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 5905200R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |