Healthcare Provider Details

I. General information

NPI: 1760862486
Provider Name (Legal Business Name): MEANINGFUL NY INITIATIVES FOR PEOPLE WITH DISABILITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 11/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PIERREPONT PLZ FL 12 300 CADMAN PLAZA WEST
BROOKLYN NY
11201-2776
US

IV. Provider business mailing address

1 PIERREPONT PLZ FL 12 300 CADMAN PLAZA WEST
BROOKLYN NY
11201-2776
US

V. Phone/Fax

Practice location:
  • Phone: 917-993-4228
  • Fax:
Mailing address:
  • Phone: 917-993-4228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number69480CH1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number69480FI1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number69480RE1
License Number StateNY

VIII. Authorized Official

Name: MR. TODD PINKUS
Title or Position: EXECUTIVE DIRECTOR
Credential: MPA, MA
Phone: 917-993-4228