Organization
BROOKLYN BOULEVARD ALP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOWARD BRUCE NEUFELD (EXECUTIVE DIRECTOR)
(718) 557-0777
Entity
Organization
Contact information
Practice address
636 LOUISIANA AVE, BROOKLYN, NY 11239-1526
(718) 557-0777
(718) 642-3510
Mailing address
636 LOUISIANA AVE, BROOKLYN, NY 11239-1526
(718) 557-0777
(718) 642-3510
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310400000X
—
NY
Enumeration date
03/14/2017
Last updated
03/14/2017
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