Healthcare Provider Details

I. General information

NPI: 1437061876
Provider Name (Legal Business Name): JK CARE SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1684 W 10TH ST APT F7
BROOKLYN NY
11223-1194
US

IV. Provider business mailing address

1684 W 10TH ST APT F7
BROOKLYN NY
11223-1194
US

V. Phone/Fax

Practice location:
  • Phone: 646-920-5833
  • Fax:
Mailing address:
  • Phone: 646-920-5833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ISMAIL KHAN
Title or Position: DIRECTOR
Credential: DO
Phone: 646-920-5833