Organization
INTERBOROUGH DEVELOPMENTAL AND CONSULTATION CENTER, INC.
Active
Other names
IDCC Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN GERSTEN (PRESIDENT)
(646) 491-3711
Entity
Organization
Contact information
Practice address
445 KINGS HWY STE 2, BROOKLYN, NY 11223-1780
(718) 645-0300
(718) 375-5920
Mailing address
445 KINGS HWY STE 2, BROOKLYN, NY 11223-1780
(718) 645-0300
(718) 375-5920
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
241211
LICENSE
NY
01
—
7001301R
LICENSE
NY
Enumeration date
11/17/2025
Last updated
03/27/2026
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