MEDICARE: LASANTE HEALTH CENTER INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QC1500X	Community Health Clinic/Center
2	261QH0100X	Health Service Clinic/Center
3	261QM1300X	Multi-Specialty Clinic/Center
4	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1548192446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LASANTE HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	646 PARKSIDE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-1506
Country	:	US
Telephone Number	:	718-246-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	646 PARKSIDE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-1506
Country	:	US
Telephone Number	:	718-246-5700
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	GEDALYA BLUMENFRUCHT
Credential	:
Telephone Number	:	718-246-5700

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “LASANTE HEALTH CENTER INC ” Practice Location

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