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NPI Code Detail

MEDICARE: ABUNDANT LIFE AGENCY

MEDICARE: ABUNDANT LIFE AGENCY
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
1314000000XSkilled Nursing Facility9108L001NY

General Provider Information

NPI Number : 1972832590
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABUNDANT LIFE AGENCY
Provider Business Mailing Address
First Line : 827 CLARKSON AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-2256
Country : US
Telephone Number : 718-735-7151
Fax Number : 718-735-7141
Provider Business Practice Location Address
First Line : 827 CLARKSON AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-2256
Country : US
Telephone Number : 718-735-7151
Fax Number : 718-735-7141
Authorized Official
Title or Position : PROGRAM COORDINATOR
Name : MR. KESTON JASON JOHN
Credential :
Telephone Number : 718-735-7151
Provider Enumeration Date : 12/10/2009
Last Update Date : 12/10/2009

Similar Medicare Providers

1992903736 — ABUNDANT LIFE AGENCY, INC.
Practice Location Address:
827 CLARKSON AVE
BROOKLYN, NY
11203-2256
Practice Phone: 718-735-7151
Practice Fax:
1770839011 — MRS. JOHANN ANDRIA RICHARDSON
Practice Location Address:
827 CLARKSON AVE
BROOKLYN, NY
11203-2256
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Practice Fax: 718-735-7141
1922354216 — MS. MACKLAINE M VIELOT
Practice Location Address:
827 CLARKSON AVE , TOP FLOOR
BROOKLYN, NY
11203-2256
Practice Phone: 718-735-7151
Practice Fax:
1285980201 — DR. JOSEPHINE UZOAMAKA AGUOJI SPECIAL ED. TEACHER
Practice Location Address:
827 CLARKSON AVE
BROOKLYN, NY
11203-2256
Practice Phone: 718-735-7151
Practice Fax:
1932455763 — MERCEDES ELLIS MSCED
Practice Location Address:
827 CLARKSON AVE
BROOKLYN, NY
11203-2256
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Practice Fax: 718-735-7141
1245586791 — MS. ANNETTE DAVID
Practice Location Address:
827 CLARKSON AVE
BROOKLYN, NY
11203-2256
Practice Phone: 718-735-7151
Practice Fax: 718-735-7141

Directions to “ABUNDANT LIFE AGENCY ” Practice Location

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