Organization
KEW GARDENS SEP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONID YAKUBOV O.T. (EXECTIVE DIRECTOR)
(718) 263-5437
Entity
Organization
Contact information
Practice address
15916 UNION TPKE, SUITE 308, FRESH MEADOWS, NY 11366-1954
(718) 263-5437
(718) 263-5444
Mailing address
159-16 UNION TPKE, SUITE 308, FRESH MEADOWS, NY 11375
(718) 263-5437
(718) 263-5444
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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