MEDICARE: NORTHEAST BRONX DAY CARE CENTER, INC.

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1508126616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEAST BRONX DAY CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	4102 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-3008
Country	:	US
Telephone Number	:	718-547-1245
Fax Number	:	718-547-6302

Provider Business Practice Location Address
First Line	:	4102 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-3008
Country	:	US
Telephone Number	:	718-547-1245
Fax Number	:	718-547-6302

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. JOYCE L. JAMES
Credential	:	PHD
Telephone Number	:	718-547-1245

Provider Enumeration Date	:	05/22/2012
Last Update Date	:	05/22/2012

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