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NPI Code Detail

MEDICARE: BOULEVARD ADULT DAY CARE OF FLUSHING

MEDICARE: BOULEVARD ADULT DAY CARE OF FLUSHING
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
1261QA0600XAdult Day Care Clinic/Center

General Provider Information

NPI Number : 1346760899
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOULEVARD ADULT DAY CARE OF FLUSHING
Provider Business Mailing Address
First Line : 636 LOUISIANA AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11239-1526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 636 LOUISIANA AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11239-1526
Country : US
Telephone Number : 718-557-0999
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : MICHAEL MARX
Credential :
Telephone Number : 718-380-8882
Provider Enumeration Date : 06/26/2017
Last Update Date : 06/26/2017

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Directions to “BOULEVARD ADULT DAY CARE OF FLUSHING ” Practice Location

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