Healthcare Provider Details

I. General information

NPI: 1790301737
Provider Name (Legal Business Name): ADINA DRILLICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 38TH ST
BROOKLYN NY
11218-3612
US

IV. Provider business mailing address

1542 E 33RD ST
BROOKLYN NY
11234-3457
US

V. Phone/Fax

Practice location:
  • Phone: 718-686-3700
  • Fax:
Mailing address:
  • Phone: 917-244-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-65601
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: