Healthcare Provider Details

I. General information

NPI: 1780424812
Provider Name (Legal Business Name): A LEON BRIGHTER FUTURE. II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W KINGSBRIDGE RD APT 5H
BRONX NY
10463-7316
US

IV. Provider business mailing address

201 W KINGSBRIDGE RD APT 5H
BRONX NY
10463-7316
US

V. Phone/Fax

Practice location:
  • Phone: 201-497-4102
  • Fax:
Mailing address:
  • Phone: 201-497-4102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ARLENE N IFILL LEON
Title or Position: SPECIAL EDUCATION TEACHER
Credential: MS ED.
Phone: 917-628-5277