=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437527918
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LLJSOLUTIONS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2015
-----------------------------------------------------
Last Update Date | 09/14/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3416 FARRAGUT RD
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11210-2741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-249-7512
-----------------------------------------------------
Fax | 718-434-5669
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3416 FARRAGUT RD
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11210-2741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-249-7512
-----------------------------------------------------
Fax | 718-434-5669
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | MS. LOUCINA ANGELINA SKRINE
-----------------------------------------------------
Credential | M,S, SPEC,ED
-----------------------------------------------------
Telephone | 347-249-7512
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------