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NPI Code Detail

MEDICARE: CARL FENICHEL COMMUNITY SERVICES

MEDICARE: CARL FENICHEL COMMUNITY SERVICES
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
1251C00000XDevelopmentally Disabled Services Day Training Agency

Other Identifiers

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

General Provider Information

NPI Number : 1790965655
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARL FENICHEL COMMUNITY SERVICES
Provider Business Mailing Address
First Line : 483 CLERMONT AVENUE
Second Line : 3RD FLOOR
City : BROOKLYN
State : NY
Zip : 11238-2253
Country : US
Telephone Number : 718-643-5300
Fax Number : 718-643-0640
Provider Business Practice Location Address
First Line : 483 CLERMONT AVE
Second Line : 3RD FLOOR
City : BROOKLYN
State : NY
Zip : 11238-2253
Country : US
Telephone Number : 718-643-5300
Fax Number : 718-643-0640
Authorized Official
Title or Position : COMPTROLLER
Name : MR. LEON FISHMAN
Credential :
Telephone Number : 718-634-5300
Provider Enumeration Date : 11/08/2007
Last Update Date : 02/29/2016

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Directions to “CARL FENICHEL COMMUNITY SERVICES ” Practice Location

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