Organization
6677 BROADWAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA BORUKHOVA (OFFICE MANAGER)
(718) 938-7183
Entity
Organization
Contact information
Practice address
140 BEACH 119TH ST, ROCKAWAY PARK, NY 11694-1953
(718) 938-7183
Mailing address
4718 18TH AVE STE 26, BROOKLYN, NY 11204-1260
(718) 938-7183
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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