MEDICARE: HUMAN DEVELOPMENT ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	0553L001	NY

General Provider Information

NPI Number	:	1326167719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMAN DEVELOPMENT ASSOCIATION

Provider Business Mailing Address
First Line	:	12 HEYWARD ST
Second Line	:	4TH FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11211-7839
Country	:	US
Telephone Number	:	718-422-4700
Fax Number	:	718-855-4500

Provider Business Practice Location Address
First Line	:	12 HEYWARD ST
Second Line	:	4TH FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11211-7839
Country	:	US
Telephone Number	:	718-422-4700
Fax Number	:	718-855-4500

Authorized Official
Title or Position	:	EXEC. DIRECTOR
Name	:	YECHIEL GRUENWALD
Credential	:
Telephone Number	:	718-422-4700

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	08/22/2020

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