Healthcare Provider Details

I. General information

NPI: 1093546285
Provider Name (Legal Business Name): HARMONY BRIDGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 60TH ST
WEST NEW YORK NJ
07093-1329
US

IV. Provider business mailing address

449 60TH ST FL 2
WEST NEW YORK NJ
07093-2211
US

V. Phone/Fax

Practice location:
  • Phone: 718-973-0677
  • Fax: 862-416-2568
Mailing address:
  • Phone: 718-973-0677
  • Fax: 862-416-2568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RAFAEL JIMENEZ
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 718-973-0677