Organization
YENNIS COLON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALENA GELLERMAN (HUMAN RESOURCE DIRECTOR)
(718) 375-1200
Entity
Organization
Contact information
Practice address
1623 KINGS HWY, BROOKLYN, NY 11229-1209
(718) 375-1200
Mailing address
1623 KINGS HWY, BROOKLYN, NY 11229-1209
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097101
LMSW
NY
Enumeration date
03/29/2016
Last updated
03/29/2016
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