MEDICARE: BROOKLYN ENTREPRENEURS 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	1041C0700X	Clinical Social Worker
2	225100000X	Physical Therapist
3	225X00000X	Occupational Therapist
4	235Z00000X	Speech-Language Pathologist	0206561	NY

General Provider Information

NPI Number	:	1508238981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKLYN ENTREPRENEURS INC

Provider Business Mailing Address
First Line	:	847 BEDFORD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-2801
Country	:	US
Telephone Number	:	718-938-8293
Fax Number	:

Provider Business Practice Location Address
First Line	:	847 BEDFORD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-2801
Country	:	US
Telephone Number	:	718-938-8293
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ABRAHAM CHAIM
Credential	:
Telephone Number	:	718-522-5559

Provider Enumeration Date	:	10/26/2015
Last Update Date	:	10/19/2017

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