Provider Demographics
NPI:1831462795
Name:KNESSET ADULT SOCIAL DAAY CARE,, IC.
Entity Type:Organization
Organization Name:KNESSET ADULT SOCIAL DAAY CARE,, IC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KISELEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-570-2850
Mailing Address - Street 1:223 BRIGHTON BEACH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7406
Mailing Address - Country:US
Mailing Address - Phone:917-570-2850
Mailing Address - Fax:347-772-3663
Practice Address - Street 1:223 BRIGHTON BEACH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7406
Practice Address - Country:US
Practice Address - Phone:917-570-2850
Practice Address - Fax:347-772-3663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization