Healthcare Provider Details

I. General information

NPI: 1326623885
Provider Name (Legal Business Name): SKA THERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2021
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 ALCOTT PLACE
BRONX NY
10475
US

IV. Provider business mailing address

177A E MAIN ST STE 462
NEW ROCHELLE NY
10801-5711
US

V. Phone/Fax

Practice location:
  • Phone: 914-409-9699
  • Fax:
Mailing address:
  • Phone: 914-409-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHEILA ESTHER KUSI-ASARE
Title or Position: SOCIAL WORKER
Credential: LMSW
Phone: 917-500-4611