Organization
DEPARTMENT OF EDUCATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSY WARREN (REGISTERED NURSE)
(718) 464-5763
Entity
Organization
Contact information
Practice address
18910 RADNOR RD, JAMAICA ESTATES, NY 11423-1021
(718) 468-3742
Mailing address
65 COURT ST, BROOKLYN, NY 11201-4926
(718) 464-5763
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
491242-1
NY
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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