Provider Demographics
NPI:1639361637
Name:BUSHWICK ECONOMIC DEVELOPMENT CORP
Entity Type:Organization
Organization Name:BUSHWICK ECONOMIC DEVELOPMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:BA DEGREE
Authorized Official - Phone:718-628-3102
Mailing Address - Street 1:61 COOPER
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1413
Mailing Address - Country:US
Mailing Address - Phone:718-628-3102
Mailing Address - Fax:718-573-6294
Practice Address - Street 1:629 CHAUNCEY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1413
Practice Address - Country:US
Practice Address - Phone:718-628-3102
Practice Address - Fax:718-573-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility