Provider Demographics
NPI:1235311846
Name:ASSOCIATION FOR THE ADVANCEMENT OF BLIND AND RETARDED INC
Entity Type:Organization
Organization Name:ASSOCIATION FOR THE ADVANCEMENT OF BLIND AND RETARDED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSNACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-321-3800
Mailing Address - Street 1:PO BOX 560247
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356
Mailing Address - Country:US
Mailing Address - Phone:718-321-3800
Mailing Address - Fax:718-321-8688
Practice Address - Street 1:178-06 LINDEN BOULEVARD
Practice Address - Street 2:
Practice Address - City:ST ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412
Practice Address - Country:US
Practice Address - Phone:718-657-5718
Practice Address - Fax:718-657-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00356863Medicaid