Healthcare Provider Details
I. General information
NPI: 1669816708
Provider Name (Legal Business Name): B'KAVOD/WITH RESPECT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2013
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14730 73RD AVE
FLUSHING NY
11367-2930
US
IV. Provider business mailing address
14121 70TH RD
FLUSHING NY
11367-1936
US
V. Phone/Fax
- Phone: 718-300-0234
- Fax:
- Phone: 718-300-0234
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REUVEN
BECKER
Title or Position: DIRECTOR
Credential: MBA, MS, ORD.
Phone: 718-300-0234