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Organization
INTERBOROUGH DEVELOPMENTAL AND CONSULTATION CENTER
Active
Organization
INTERBOROUGH DEVELOPMENTAL AND CONSULTATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES RUSK (SOCIAL WORKER)
(718) 909-7544
Entity
Organization
Contact information
Practice address
1670-78 EAST 17TH STREET, 3RD FL., BROOKLYN, NY 11229
(718) 375-1200
(718) 382-3358
Mailing address
436 PROSPECT AVENUE, APT. 3L, BROOKLYN, NY 11215
(718) 909-7544
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0718201
NY
Other
Enumeration date
07/18/2006
Last updated
08/22/2020
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