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General NPI Number Information
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NPI Number | 1770046658
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Entity Type | Individual
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Provider Name | ROBERT ELLIS POWER JR. PH. D
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Gender | Male
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 1007 ATLANTIC AVE APT 4D
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City | BROOKLYN
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State | NY
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Zip | 11238-3469
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Country | US
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Telephone | 516-586-0001
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Fax | 516-530-1838
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Provider Business Mailing Address
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Address Line | 77 SANDS ST FL 6
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City | BROOKLYN
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State | NY
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Zip | 11201-1431
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Country | US
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Telephone | 516-586-0001
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Fax | 516-530-1838
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | EXEMPT
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 3476
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 3476
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 35587
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License Number State | NY
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