Provider Demographics
NPI:1801213723
Name:GLORIA B. ROSE CENTER FOR CHILDREN, INC.
Entity Type:Organization
Organization Name:GLORIA B. ROSE CENTER FOR CHILDREN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:PINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-397-3720
Mailing Address - Street 1:PO BOX 70598
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-0598
Mailing Address - Country:US
Mailing Address - Phone:347-397-3720
Mailing Address - Fax:
Practice Address - Street 1:61 BRADFORD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2501
Practice Address - Country:US
Practice Address - Phone:347-397-3720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service