Basic Information
| Provider Information | |||||||||
| NPI: | 1659880383 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 135 W 50TH ST | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100201201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 19147737343 | ||||||||
| FaxNumber: | 2125848478 | ||||||||
| Practice Location | |||||||||
| Address1: | 1007 QUENTIN RD | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112232341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188969090 | ||||||||
| FaxNumber: | 7188300724 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2017 | ||||||||
| LastUpdateDate: | 09/26/2017 | ||||||||
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| AuthorizedOfficialLastName: | BRENNAN | ||||||||
| AuthorizedOfficialFirstName: | ANDRIA | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | ASSISTANT DIRECTOR REVENUE CYCLE M | ||||||||
| AuthorizedOfficialTelephone: | 9147737343 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 6709117A | NY | Y | Agencies | Community/Behavioral Health |
No ID Information.