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NPI Code Detail

MEDICARE: ABUNDANT LIFE AGENCY, INC.

MEDICARE: ABUNDANT LIFE AGENCY, 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
1251E00000XHome Health Agency9108L001NY

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 : 1992903736
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABUNDANT LIFE AGENCY, INC.
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 :
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 :
Authorized Official
Title or Position : C.E.O.
Name : MRS. OLIVE ARCHER
Credential :
Telephone Number : 718-735-7151
Provider Enumeration Date : 07/03/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

1972832590 — ABUNDANT LIFE AGENCY
Practice Location Address:
827 CLARKSON AVE
BROOKLYN, NY
11203-2256
Practice Phone: 718-735-7151
Practice Fax: 718-735-7141
1770839011 — MRS. JOHANN ANDRIA RICHARDSON
Practice Location Address:
827 CLARKSON AVE
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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
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Practice Fax:
1932455763 — MERCEDES ELLIS MSCED
Practice Location Address:
827 CLARKSON AVE
BROOKLYN, NY
11203-2256
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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, INC. ” Practice Location

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