Healthcare Provider Details

I. General information

NPI: 1639891377
Provider Name (Legal Business Name): CLOSE AT HEART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 EMPIRE BLVD
BROOKLYN NY
11225-3402
US

IV. Provider business mailing address

209 EMPIRE BLVD
BROOKLYN NY
11225-3402
US

V. Phone/Fax

Practice location:
  • Phone: 718-305-6200
  • Fax:
Mailing address:
  • Phone: 718-557-7717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ISRAEL RABINOWITZ
Title or Position: MANAGING MEMBER
Credential:
Phone: 718-557-7717