NPIMap

Organization Active NPI

Avenue K (Icl)

  • Developmentally Disabled Services Day Training Agency
  • Brooklyn, NY
National Provider Identifier
1699891911
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
AVENUE K (ICL)
Practice address
9001 Avenue K
Brooklyn, NY 11236-4215
Phone
(718) 341-6091
NPI assigned
Mar 21, 2007
Last updated
Jun 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Authorized official

Name
Mr. Dewey H. 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

9001 Avenue K
Brooklyn, NY 11236-4215

Mailing address

125 Broad Street
3Rd Floor
New York, NY 10004-2400
Phone (212) 385-3030

Other identifiers 1

IdentifierTypeStateIssuer
01410099MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Icl Bronx Park East35 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

Locations

9001 Avenue K
Brooklyn, NY 11236
Phone (718) 341-6091

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1699891911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BROAD STREET",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042400",
            "telephone_number": "212-385-3030",
            "fax_number": "917-831-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 AVENUE K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364215",
            "telephone_number": "718-341-6091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENUE K (ICL)",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "DEWEY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "212-385-3030",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Jun 17, 2015; 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.