Protestant Board of Guardians Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PROTESTANT BOARD OF GUARDIANS INC

Practice address

1368 Fulton St
2ND Floor
Brooklyn, NY 11216-2635

Phone

(718) 636-8103

Fax

(718) 636-8616

NPI assigned

Mar 10, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert B Greene, LCSWR

Title

Executive Director

Phone

(718) 636-8103

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1063682623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1368 FULTON ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162635",
            "telephone_number": "718-636-8103",
            "fax_number": "718-636-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 FULTON ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162635",
            "telephone_number": "718-636-8103",
            "fax_number": "718-636-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTESTANT BOARD OF GUARDIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-636-8103",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSWR"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02376887",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.