MEDICARE: RCJ SERVICES, 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	252Y00000X	Early Intervention Provider Agency	128487916	NY

General Provider Information

NPI Number	:	1699126524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RCJ SERVICES, INC

Provider Business Mailing Address
First Line	:	3855 SHORE PKWY
Second Line	:	2H
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1038
Country	:	US
Telephone Number	:	908-797-9711
Fax Number	:	718-759-3902

Provider Business Practice Location Address
First Line	:	3855 SHORE PKWY
Second Line	:	2H
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1038
Country	:	US
Telephone Number	:	908-797-9711
Fax Number	:	718-759-3902

Authorized Official
Title or Position	:	SPECIAL EDUCATION INSTRUCTOR
Name	:	MR. RON GILL
Credential	:	MS EDUCATION
Telephone Number	:	908-797-9711

Provider Enumeration Date	:	06/22/2016
Last Update Date	:	06/22/2016

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