| Institute For Community Living , Inc. | |
|
2581 Atlantic Ave Brooklyn NY 11207 | |
| (718) 272-6074 | |
| Not Available |
| Full Name | Institute For Community Living , Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2581 Atlantic Ave, Brooklyn, New York |
| Authorized Official Name and Position | Nikant Ohri (EVPCFO) |
| Authorized Official Contact | 2123853030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Institute For Community Living , Inc. 125 Broad St 3rd Floor New York NY 10004-2400 Ph: (212) 385-3030 | Institute For Community Living , Inc. 2581 Atlantic Ave Brooklyn NY 11207 Ph: (718) 272-6074 |
| NPI Number | 1558494930 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 06/22/2018 |
| Medicare PECOS PAC ID | 3870482391 |
|---|---|
| Medicare Enrollment ID | O20040312000818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558494930 | NPI | - | NPPES |
| 01551404 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Pamela Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457493900 PECOS PAC ID: 3173702305 Enrollment ID: I20110120000482 |
| Provider Name | Joseph N Voigt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326075888 PECOS PAC ID: 3870773385 Enrollment ID: I20110216000011 |
| Provider Name | Michelle P Kaplan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124167267 PECOS PAC ID: 4688854151 Enrollment ID: I20110216000060 |
| Provider Name | Anush Azduni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134272461 PECOS PAC ID: 8022279116 Enrollment ID: I20120417000598 |
| Provider Name | Kay Rothenberg-hosny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912145061 PECOS PAC ID: 9931360955 Enrollment ID: I20120418000161 |
| Provider Name | Ellen B Tabor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285619379 PECOS PAC ID: 2264688753 Enrollment ID: I20120816000544 |
| Provider Name | Miklos F Losonczy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326069519 PECOS PAC ID: 9032399506 Enrollment ID: I20121119000515 |
| Provider Name | Natalie L Wisdom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992833933 PECOS PAC ID: 1850540980 Enrollment ID: I20140428001521 |
| Provider Name | Shoshannah Pearlman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114368370 PECOS PAC ID: 9638302177 Enrollment ID: I20140507001049 |
| Provider Name | Michelle Angela Salvaggio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619900222 PECOS PAC ID: 8022231851 Enrollment ID: I20140524000116 |
| Provider Name | Elissa M Lapide |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821247735 PECOS PAC ID: 8527246008 Enrollment ID: I20140605000907 |
| Provider Name | Sonia O Munro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316241276 PECOS PAC ID: 3173747763 Enrollment ID: I20140623001527 |
| Provider Name | Marda N Yilma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972658946 PECOS PAC ID: 0042434516 Enrollment ID: I20140624001842 |
| Provider Name | Tracy M Norris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821269671 PECOS PAC ID: 4385862226 Enrollment ID: I20140905001609 |
| Provider Name | Evelyn T Escobar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326362153 PECOS PAC ID: 8224265194 Enrollment ID: I20141006000766 |
| Provider Name | Jean Luther Painson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881969251 PECOS PAC ID: 5991029415 Enrollment ID: I20150109001667 |
| Provider Name | Glen P Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912128356 PECOS PAC ID: 1850619180 Enrollment ID: I20150416000374 |
| Provider Name | Odile Mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114257904 PECOS PAC ID: 1759691728 Enrollment ID: I20151103001025 |
| Provider Name | Virginia Roper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538476163 PECOS PAC ID: 5395982557 Enrollment ID: I20151211002306 |
| Provider Name | Sonea Mahboob |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790063402 PECOS PAC ID: 0244523645 Enrollment ID: I20160722000739 |
| Provider Name | Colette B Russen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780042606 PECOS PAC ID: 6507153616 Enrollment ID: I20160916001654 |
| Provider Name | Helen G Unger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467796938 PECOS PAC ID: 8820378375 Enrollment ID: I20161129002497 |
| Provider Name | Drucilla L Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487165585 PECOS PAC ID: 0042577298 Enrollment ID: I20171127001974 |
| Provider Name | Maria Apuzzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356642607 PECOS PAC ID: 8820357940 Enrollment ID: I20180118001665 |
| Provider Name | Joy O Jegede |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326551508 PECOS PAC ID: 8729348511 Enrollment ID: I20180216002052 |
| Provider Name | Jorge L Suria-colon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851593057 PECOS PAC ID: 0244456507 Enrollment ID: I20181107001306 |
| Provider Name | Evangelos Karfakis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326591520 PECOS PAC ID: 5799012548 Enrollment ID: I20190816000718 |
| Provider Name | Carline Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447342597 PECOS PAC ID: 0547697377 Enrollment ID: I20200217002510 |
| Provider Name | Elyssa J Alpert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356856884 PECOS PAC ID: 2163832056 Enrollment ID: I20201104001325 |
| Provider Name | Edward M Tabasky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962817866 PECOS PAC ID: 4385057769 Enrollment ID: I20201231001571 |
| Provider Name | Farah F Morain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427463579 PECOS PAC ID: 7012320898 Enrollment ID: I20210115002212 |
| Provider Name | Kerrigan P Hummel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306383948 PECOS PAC ID: 2668885328 Enrollment ID: I20210119002561 |
| Provider Name | Thomas Npp Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316587207 PECOS PAC ID: 8820403041 Enrollment ID: I20210222002599 |
| Provider Name | Brianna N Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629621032 PECOS PAC ID: 5698181519 Enrollment ID: I20210301001865 |
| Provider Name | Adewunmi Julius Bankole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912453788 PECOS PAC ID: 0840690459 Enrollment ID: I20210617002200 |
| Provider Name | Angelita Cordova-hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760055602 PECOS PAC ID: 4183013592 Enrollment ID: I20211104002901 |
| Provider Name | Javier L Aget-torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033886122 PECOS PAC ID: 9032500368 Enrollment ID: I20211221002895 |
| Provider Name | Jose A Alvear |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366995714 PECOS PAC ID: 8820466618 Enrollment ID: I20221129002042 |
| Provider Name | Jennifer M Knowles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922585827 PECOS PAC ID: 4880063171 Enrollment ID: I20221208000883 |
| Provider Name | Lookman Abiola Akintunde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114242567 PECOS PAC ID: 9638544240 Enrollment ID: I20230413001438 |
| Provider Name | Damara O Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619370533 PECOS PAC ID: 2062878622 Enrollment ID: I20230524001114 |
| Provider Name | Ashley R David |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841928892 PECOS PAC ID: 6002275104 Enrollment ID: I20230707001922 |
| Provider Name | Danielle E Cora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508562133 PECOS PAC ID: 9931563681 Enrollment ID: I20230913002326 |
| Provider Name | Caitlyn E La Tronica |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346998184 PECOS PAC ID: 7810341351 Enrollment ID: I20231002002510 |
| Provider Name | Mamadou A Barry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114621653 PECOS PAC ID: 2769837848 Enrollment ID: I20231010000830 |
| Provider Name | Sarah L Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558145441 PECOS PAC ID: 0244685808 Enrollment ID: I20231017002349 |
| Provider Name | Christopher T Dennis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225440084 PECOS PAC ID: 9436535598 Enrollment ID: I20231020000077 |
| Provider Name | Adelagun O Adelaja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114694858 PECOS PAC ID: 4486000635 Enrollment ID: I20231025001282 |
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