Active NPI
Evelyn Douglin Center Spin
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Brooklyn, NY
National Provider Identifier
1972049039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Legal business name
- EVELYN DOUGLIN CENTER SPIN
- Practice address
- 163 Riverdale Ave
Brooklyn, NY 11212-5579 - Phone
- (718) 965-1998
- NPI assigned
- Jan 13, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniella Volcy
- Title
- Aed
- Phone
- (718) 965-1998
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | NY | Primary | |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X |
Addresses
Primary practice location
163 Riverdale Ave
Brooklyn, NY 11212-5579
Mailing address
241 37TH St
Brooklyn, NY 11232-2417
Phone (718) 965-1998
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9058471 | Medicaid | NY | |
| 9058472 | Medicaid | NY |
National Provider Directory
National Provider Directory- Tax ID family
- Evelyn Douglin Center Spin
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Brooklyn, NY
- NPI 1891232179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484265600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1487116800000",
"number": "1972049039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241 37TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112322417",
"telephone_number": "718-965-1998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 RIVERDALE AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112125579",
"telephone_number": "718-965-1998"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVELYN DOUGLIN CENTER SPIN",
"organizational_subpart": "NO",
"enumeration_date": "2017-01-13",
"last_updated": "2017-02-15",
"status": "A",
"authorized_official_last_name": "VOLCY",
"authorized_official_first_name": "DANIELLA",
"authorized_official_title_or_position": "AED",
"authorized_official_telephone_number": "718-965-1998"
},
"taxonomies": [
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NY",
"license": null,
"primary": true
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9058471",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9058472",
"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 Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.