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NPI Code Detail

MEDICARE: THERACARE

MEDICARE: THERACARE
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
1251300000XLocal Education Agency (LEA)20058085NY
2252Y00000XEarly Intervention Provider Agency1164785150NY
3252Y00000XEarly Intervention Provider Agency20058087NY

General Provider Information

NPI Number : 1801288329
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERACARE
Provider Business Mailing Address
First Line : 111 LIVINGSTON ST STE 1101
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5068
Country : US
Telephone Number : 212-564-2350
Fax Number :
Provider Business Practice Location Address
First Line : 111 LIVINGSTON ST STE 1101
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5068
Country : US
Telephone Number : 212-564-2350
Fax Number :
Authorized Official
Title or Position : AGENCY LIAISON
Name : KELCEY OYENIYI
Credential :
Telephone Number : 212-564-2350
Provider Enumeration Date : 02/20/2015
Last Update Date : 02/20/2015

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Directions to “THERACARE ” Practice Location

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