Healthcare Provider Details

I. General information

NPI: 1699011304
Provider Name (Legal Business Name): CREATIVE SOLUTIONS NETWORK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2012
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 E 149TH ST 5TH FLOOR
BRONX NY
10451-5603
US

IV. Provider business mailing address

349 E 149TH ST 5TH FLOOR
BRONX NY
10451-5603
US

V. Phone/Fax

Practice location:
  • Phone: 646-434-5861
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMIL EFREM
Title or Position: OFFICER
Credential:
Phone: 646-434-5861