Provider Demographics
NPI:1225385016
Name:ACI
Entity Type:Organization
Organization Name:ACI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:MELANY
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-644-5710
Mailing Address - Street 1:9805 67TH AVE
Mailing Address - Street 2:APT 12A
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4969
Mailing Address - Country:US
Mailing Address - Phone:718-644-5710
Mailing Address - Fax:
Practice Address - Street 1:9805 67TH AVE
Practice Address - Street 2:APT 12A
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4969
Practice Address - Country:US
Practice Address - Phone:718-644-5710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY644541313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility