Healthcare Provider Details

I. General information

NPI: 1215860978
Provider Name (Legal Business Name): BRAVE STAR HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 N CENTRAL AVE STE 1000
PHOENIX AZ
85004-1027
US

IV. Provider business mailing address

755 KENT AVE APT 713
BROOKLYN NY
11249-8210
US

V. Phone/Fax

Practice location:
  • Phone: 718-935-9400
  • Fax: 347-435-2488
Mailing address:
  • Phone: 718-935-9400
  • Fax: 347-435-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: FAIGY SCHNEEBALG
Title or Position: ADMIN
Credential:
Phone: 718-504-0021