MEDICARE: BRIGHT FUTURE FOR THE CHILDREN

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	251B00000X	Case Management Agency
2	252Y00000X	Early Intervention Provider Agency		NY

General Provider Information

NPI Number	:	1679920490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT FUTURE FOR THE CHILDREN

Provider Business Mailing Address
First Line	:	119 SCHENECTADY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-2330
Country	:	US
Telephone Number	:	917-731-0570
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 SCHENECTADY AVE FL 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-2330
Country	:	US
Telephone Number	:	347-915-1112
Fax Number	:	347-915-1113

Authorized Official
Title or Position	:	CEO
Name	:	DANIE MASCARY
Credential	:	LMSW
Telephone Number	:	917-731-0570

Provider Enumeration Date	:	05/22/2016
Last Update Date	:	03/02/2017

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