Healthcare Provider Details

I. General information

NPI: 1821907510
Provider Name (Legal Business Name): CIRCLE OF SUNSHINE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2944 W 5TH ST
BROOKLYN NY
11224-3800
US

IV. Provider business mailing address

2944 W 5TH ST APT 17H
BROOKLYN NY
11224-3847
US

V. Phone/Fax

Practice location:
  • Phone: 646-541-5645
  • Fax:
Mailing address:
  • Phone: 646-541-5645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BEATA DERKACH
Title or Position: PRESIDENT
Credential: MD
Phone: 646-541-5645