MEDICARE: BILLWELL CORPORATION

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	252Y00000X	Early Intervention Provider Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1679308738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BILLWELL CORPORATION

Provider Business Mailing Address
First Line	:	178 NORFOLK ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2306
Country	:	US
Telephone Number	:	917-318-2223
Fax Number	:

Provider Business Practice Location Address
First Line	:	178 NORFOLK ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2306
Country	:	US
Telephone Number	:	917-318-2223
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	NATALIE MASHKEVICH
Credential	:
Telephone Number	:	917-318-2233

Provider Enumeration Date	:	09/06/2024
Last Update Date	:	09/06/2024

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Directions to “BILLWELL CORPORATION ” Practice Location

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