0920-0891 WTCHP Clinic Selection Postcard_10FEB2025

OMB No. 0920-0891
Exp. Date 09/30/2025
First Name:
Last Name:
Member ID #:
Please select one WTC Health Program Clinical Center of Excellence that you wish to visit for your monitoring exams and
any necessary treatment. Please return this card within 30 days. If we do not receive your card within 30 days, you will
automatically be assigned to the clinic location nearest the home address you have provided.
Icahn School of Medicine at Mount Sinai
Selikoff Centers for Occupational Health
Three locations (choose one):
Manhattan Clinical Center
1468 Madison Ave, 3rd Floor
New York, NY 10029
Staten Island Clinical Center
2052 Richmond Rd, Ste 2A
Staten Island, NY 10306
Rockland County Clinical Center
222 Route 59
Suffern, NY 10901
New York University Grossman School of
Medicine
650 First Ave, 7th Floor, WTC Suite
New York, NY 10016

Northwell WTC Clinical Center
97-77 Queens Blvd, 9th Floor
Rego Park, NY 11374
Rutgers University

Environmental & Occupational Health Sciences Institute

170 Frelinghuysen Rd
Piscataway, NJ 08854

State University of New York - Stony Brook
Stony Brook WTC Wellness Program
Two locations:
Suffolk County (Main Clinic)
500 Commack Rd, Ste 160
Commack, NY 11725
Nassau County (Satellite Clinic)
173 Mineola Blvd, Ste 302
Mineola, NY 11501

To protect your privacy, please fold and seal this card before mailing.

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Atlanta, Georgia 30333; ATTN: PRA (0920-0891).