1497095582 NPI number — CLARENDON D. GARDEN SOCIAL DAYCARE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497095582 NPI number — CLARENDON D. GARDEN SOCIAL DAYCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLARENDON D. GARDEN SOCIAL DAYCARE
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:
1497095582
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20514 LINDEN BLVD
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
SAINT ALBANS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11412-2900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-528-5493
Provider Business Mailing Address Fax Number:
718-525-4305

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2504 CLARENDON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11226-6208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-528-5493
Provider Business Practice Location Address Fax Number:
718-525-4305
Provider Enumeration Date:
02/26/2013

Additional Information

Authorized Official

Authorized Official Last Name:
POWELL
Authorized Official First Name:
JANETTE
Authorized Official Middle Name:
F
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
646-789-7761

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X , 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)





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