Provider Demographics
NPI:1336426964
Name:JEWISH BOARD OF FAMILY @ CHIDLREN SERVICES
Entity Type:Organization
Organization Name:JEWISH BOARD OF FAMILY @ CHIDLREN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:FABILOA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-327-7660
Mailing Address - Street 1:8430 127TH ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2825
Mailing Address - Country:US
Mailing Address - Phone:347-898-6954
Mailing Address - Fax:
Practice Address - Street 1:2002 SEAGIRT BLVD
Practice Address - Street 2:BASEMENT APT
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-2800
Practice Address - Country:US
Practice Address - Phone:718-327-7660
Practice Address - Fax:718-327-4230
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSITION CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization