Organization
1377 EAST 17TH STREET LLC
Active
Parent organization
1377 EAST 17TH STREET LLC
Other names
Angie Wassif
Organization subpart
Yes
Provider details
NPI number
Legal business name
1377 EAST 17TH STREET LLC
Authorized official
ANGIE WASSIF (DIRECTOR)
(717) 802-8558
Entity
Organization
Contact information
Practice address
3626 BAYVIEW AVE, BROOKLYN, NY 11224-1647
(718) 802-8558
Mailing address
3626 BAYVIEW AVE, BROOKLYN, NY 11224-1647
(717) 802-8558
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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