Children Services Broaden, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CHILDREN SERVICES BROADEN, LLC

Practice address

1838 Chowan St
Elmont, NY 11003-1741

Phone

(631) 743-0159

NPI assigned

May 29, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Shirley Sims, MSED

Title

Special Instructor

Phone

(631) 743-0159

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1811554512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30633",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110030633",
            "telephone_number": "347-515-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 CHOWAN ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031741",
            "telephone_number": "631-743-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN SERVICES BROADEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "SPECIAL INSTRUCTOR",
        "authorized_official_telephone_number": "631-743-0159",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSED"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Pierre Chery-Moise, LPN
• Nancia Chery, REGISTERED DIETITIAN
• Shanna Chery, MS,OTR/L
• Stacy Chery, RN
• Maggie Wei Cheung, R.PH.
• Vernon Anthony Chin, PA
• Aziz Chowdhury, PA-C
• Sana Chowdhury, PA
• Antonetta Ciminelli, M. A. CCC-SLP, TSHH
• Audrey Cineas, RN

• Specialist in Elmont, NY
• Providers in Elmont, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.