Organization
KINGSBAY YM-YWHA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONARD PETLAKH (EXECUTIVE DIRECTOR)
(718) 648-7703
Entity
Organization
Contact information
Practice address
3495 NOSTRAND AVE, BROOKLYN, NY 11229-5131
(718) 648-7703
(718) 648-0758
Mailing address
3495 NOSTRAND AVE, BROOKLYN, NY 11229-5131
(718) 648-7703
(718) 648-0758
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2008
Last updated
01/18/2008
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