Healthcare Provider Details

I. General information

NPI: 1467869602
Provider Name (Legal Business Name): PROVIDENCE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
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:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateNY

VIII. Authorized Official

Name: LEOPOLD FRIEDMAN
Title or Position: BOARD OF DIRECTORS
Credential:
Phone: 347-461-2177