NPIMap

Organization Active NPI

St Nicks Alliance Corp.

  • In Home Supportive Care Agency
  • Brooklyn, NY
National Provider Identifier
1790046852
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
1177L001 Issued in NY
Legal business name
ST NICKS ALLIANCE CORP.
Practice address
2 Kingsland Ave
Brooklyn, NY 11211-1695
Phone
(718) 388-5454
Fax
(718) 943-3085
NPI assigned
Jun 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Mr. Michael Rochford
Title
Executive Director
Phone
(718) 388-5454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 1177L001 NY Primary

Addresses

Primary practice location

2 Kingsland Ave
Brooklyn, NY 11211-1695

Mailing address

2 Kingsland Ave
Brooklyn, NY 11211-1695
Phone (718) 388-5454

Other identifiers 1

IdentifierTypeStateIssuer
03259029MedicaidNY

Other names 1

  • St. Nicholas Neighborhood Preservation Corp Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
St Nicholas Neighborhood Preservation Corp3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1790046852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 KINGSLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112111695",
            "telephone_number": "718-388-5454",
            "fax_number": "718-943-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 KINGSLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112111695",
            "telephone_number": "718-388-5454",
            "fax_number": "718-943-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST NICKS ALLIANCE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "ROCHFORD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-388-5454",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NY",
            "license": "1177L001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03259029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Nicholas Neighborhood Preservation Corp",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 6, 2012; 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.