Provider Demographics
NPI:1699842401
Name:BLOCK INSTITUTE, INC.
Entity Type:Organization
Organization Name:BLOCK INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOLD
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:718-906-5440
Mailing Address - Street 1:376 BAY 44TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-7103
Mailing Address - Country:US
Mailing Address - Phone:718-906-5400
Mailing Address - Fax:718-946-4665
Practice Address - Street 1:2214 STILLWELL AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4250
Practice Address - Country:US
Practice Address - Phone:718-372-7227
Practice Address - Fax:718-265-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6143300261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00747402 03Medicaid