Healthcare Provider Details

I. General information

NPI: 1376617100
Provider Name (Legal Business Name): BISHOP HENRY B HUCLES ENH ADC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 HERKIMER ST
BROOKLYN NY
11233-3031
US

IV. Provider business mailing address

835 HERKIMER ST
BROOKLYN NY
11233-3031
US

V. Phone/Fax

Practice location:
  • Phone: 718-221-2600
  • Fax: 718-221-2687
Mailing address:
  • Phone: 718-221-2600
  • Fax: 718-221-2687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number7001379N
License Number StateNY

VIII. Authorized Official

Name: DR. EDNA M BARNETT
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-221-2600