NPIMap

Organization Active NPI

Icl Medicaid Service Coordination (MSC)

  • Developmentally Disabled Services Day Training Agency
  • Brooklyn, NY
National Provider Identifier
1376873265
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
ICL MEDICAID SERVICE COORDINATION (MSC)
Practice address
6209 16TH Ave
Brooklyn, NY 11204-2702
Phone
(718) 234-0073
NPI assigned
Dec 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Authorized official

Name
Dewey Howard
Title
Cfo
Phone
(212) 385-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

6209 16TH Ave
Brooklyn, NY 11204-2702

Mailing address

6209 16TH Ave
Brooklyn, NY 11204-2702
Phone (718) 234-0073

Other identifiers 1

IdentifierTypeStateIssuer
01410099MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Icl Individual Support Services35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261958400000",
    "number": "1376873265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042702",
            "telephone_number": "718-234-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042702",
            "telephone_number": "718-234-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICL MEDICAID SERVICE COORDINATION (MSC)",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-28",
        "last_updated": "2009-12-28",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "DEWEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "212-385-3030"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01410099",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.