Healthcare Provider Details

I. General information

NPI: 1003247263
Provider Name (Legal Business Name): NEW YORK'S BRIGHT START, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 STRICKLAND AVE
BROOKLYN NY
11234-6428
US

IV. Provider business mailing address

2709 STRICKLAND AVE
BROOKLYN NY
11234-6428
US

V. Phone/Fax

Practice location:
  • Phone: 917-855-8875
  • Fax:
Mailing address:
  • Phone: 917-855-8875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number016109-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number016109-1
License Number StateNY

VIII. Authorized Official

Name: MS. TATYANA BORTS
Title or Position: PRESIDENT
Credential: M.S., CCC-SLP, TSHH
Phone: 917-855-8875