Healthcare Provider Details

I. General information

NPI: 1700972114
Provider Name (Legal Business Name): BETH ABRAHAM HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 ALLERTON AVE
BRONX NY
10467-7404
US

IV. Provider business mailing address

612 ALLERTON AVE
BRONX NY
10467-7404
US

V. Phone/Fax

Practice location:
  • Phone: 718-881-3000
  • 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: STEVEN MANN
Title or Position: CFO
Credential:
Phone: 718-519-5937