Organization
NORTHSIDE BK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUCAS BALLINAS (PRESIDENT)
(718) 387-2222
Entity
Organization
Contact information
Practice address
207 BEDFORD AVE, BROOKLYN, NY 11211-3236
(718) 387-2222
Mailing address
207 BEDFORD AVE, BROOKLYN, NY 11211-3236
(718) 387-2222
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
—
—
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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