Black Ice Production

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

071465614 Issued in NY

Legal business name

BLACK ICE PRODUCTION

Practice address

1001 East Street
Brooklyn, NY 11210

Phone

(347) 240-8070

NPI assigned

Feb 23, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Andre M Gibson

Title

Manger

Phone

(347) 240-8070

Specialties & licenses 2

Addresses

Other names 1

• BLACK ICE PRO Doing business as

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1821238486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 37TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103431",
            "telephone_number": "13472408070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 EAST STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11210",
            "telephone_number": "347-240-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK ICE PRODUCTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANGER",
        "authorized_official_telephone_number": "347-240-8070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NY",
            "license": "071465614",
            "primary": true
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLACK ICE PRO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Martin Blachman, DDS
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• Rachel Black-Kutner
• Alexander Irving Black

• Developmentally Disabled Services Day Training Agency in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Developmentally Disabled Services Day Training Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.