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General NPI Number Information
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NPI Number | 1962781773
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Entity Type | Organization
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Legal Business Name | MILL BASIN DAYCARE CENTER, LLC
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 2786 E 66TH ST
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City | BROOKLYN
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State | NY
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Zip | 11234-6807
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Country | US
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Telephone | 718-909-6200
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Fax | 718-763-0401
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Provider Business Mailing Address
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Address Line | 2786 E 66TH ST
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City | BROOKLYN
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State | NY
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Zip | 11234-6807
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Country | US
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Telephone | 718-909-6200
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Fax | 718-763-0401
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ALEXANDER ZINGER
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Credential |
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Telephone | 718-909-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 082965-1
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License Number State | NY
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