MEDICARE: BRIDGING ACCESS TO CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	02249145	NY
2	324500000X	Substance Abuse Rehabilitation Facility
3	261QC1500X	Community Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528149341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGING ACCESS TO CARE, INC.

Provider Business Mailing Address
First Line	:	2261 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-6486
Country	:	US
Telephone Number	:	347-505-5117
Fax Number	:	718-623-1158

Provider Business Practice Location Address
First Line	:	2261 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-3201
Country	:	US
Telephone Number	:	347-505-5119
Fax Number	:	718-623-1158

Authorized Official
Title or Position	:	CEO
Name	:	NADINE AKINYEMI
Credential	:
Telephone Number	:	347-505-5115

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	01/30/2025

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