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NPI Code Detail

MEDICARE: MENORAH HOME AND HOSPITAL ADULT DAY PROGRAM

MEDICARE: MENORAH HOME AND HOSPITAL ADULT DAY PROGRAM
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
1261QA0600XAdult Day Care Clinic/Center7001372NNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699000687
Entity Type Code : Organization
Provider Name (Legal Business Name) : MENORAH HOME AND HOSPITAL ADULT DAY PROGRAM
Provider Business Mailing Address
First Line : 6323 7TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-4742
Country : US
Telephone Number : 718-630-2510
Fax Number : 718-759-4555
Provider Business Practice Location Address
First Line : 1516 ORIENTAL BLVD
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-2328
Country : US
Telephone Number : 718-646-4441
Fax Number :
Authorized Official
Title or Position : SENIOR VP CFO
Name : ALEXANDER BALKO
Credential :
Telephone Number : 718-491-7221
Provider Enumeration Date : 10/08/2009
Last Update Date : 10/29/2009

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