Healthcare Provider Details

I. General information

NPI: 1790616928
Provider Name (Legal Business Name): VOCATIONAL INSTRUCTION PROJECT COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 CLINTON AVE
BRONX NY
10457-6747
US

IV. Provider business mailing address

1807 CLINTON AVE
BRONX NY
10457-6747
US

V. Phone/Fax

Practice location:
  • Phone: 718-466-8903
  • Fax:
Mailing address:
  • Phone: 718-466-8903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DEBBIAN FLETCHER-BLAKE
Title or Position: CEO
Credential: NP
Phone: 718-583-5150