Provider Demographics
NPI:1881982346
Name:HEARTSHARE HUMAN SEVICES OF NEW YORK
Entity type:Organization
Organization Name:HEARTSHARE HUMAN SEVICES OF NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARINELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-422-4299
Mailing Address - Street 1:12 METROTECH CTR
Mailing Address - Street 2:29TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3632
Mailing Address - Country:US
Mailing Address - Phone:718-422-4299
Mailing Address - Fax:718-422-3324
Practice Address - Street 1:131 BAY 19TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4607
Practice Address - Country:US
Practice Address - Phone:718-676-5324
Practice Address - Fax:718-232-2359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07006335315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities