Provider Demographics
NPI:1568775294
Name:CITY PRO
Entity Type:Organization
Organization Name:CITY PRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST ASSISTANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:PHARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NOZIL
Authorized Official - Suffix:
Authorized Official - Credentials:OTA
Authorized Official - Phone:718-735-7856
Mailing Address - Street 1:1089 EASTERN PKWY
Mailing Address - Street 2:BROOKLYN
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4842
Mailing Address - Country:US
Mailing Address - Phone:718-735-7856
Mailing Address - Fax:
Practice Address - Street 1:1089 EASTERN PKWY
Practice Address - Street 2:BROOKLYN
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4842
Practice Address - Country:US
Practice Address - Phone:718-735-7856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health