Reborn for New Life LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

150211831 Issued in NY

Legal business name

REBORN FOR NEW LIFE LLC

Practice address

400 Liberty Ave
Brooklyn, NY 11207-3032

Phone

(646) 251-1400

NPI assigned

Mar 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Wilkins Williams

Title

Medical Director

Phone

(917) 553-0982

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1598181513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112073032",
            "telephone_number": "646-251-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112073032",
            "telephone_number": "646-251-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBORN FOR NEW LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "WILKINS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "917-553-0982",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "150211831",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OASAS",
            "identifier": "150211831",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valentyna Rebenchuk
• Livia Rebenwurzel
• Evan Paul Rebesque-Bolanos
• Orlee Rebibo
• Gabriel Rebick, M.D., M.P.H.
• Ray Rebortira, M.D.
• Rebound Chiropractic P.C.
• Rebound Physical Therapy and Rehabilitation Services PC
• Rebuilding the Black Nuclear Family
• Andrea Recarte

• Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.