1740596204 NPI number — BROOKLYN CONSULTANTS LLC

Table of content: (NPI 1740596204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740596204 NPI number — BROOKLYN CONSULTANTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BROOKLYN CONSULTANTS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740596204
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 219
Provider Second Line Business Mailing Address:
GRACIE STATION
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10028-0016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-768-8880
Provider Business Mailing Address Fax Number:
718-768-8180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
503 5TH AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215-4811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-768-8880
Provider Business Practice Location Address Fax Number:
718-768-8180
Provider Enumeration Date:
08/23/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BELTRAN
Authorized Official First Name:
BROOKE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
516-413-8635

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  2573601 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)