Icl Healthcare Choices Inc | |
179 Jamaica Ave Brooklyn NY 11207-2049 | |
(929) 267-5354 | |
(929) 267-5340 |
Full Name | Icl Healthcare Choices Inc |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 179 Jamaica Ave, Brooklyn, New York |
Authorized Official Name and Position | Maria Siebel (CEO) |
Authorized Official Contact | 7182340073 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Icl Healthcare Choices Inc 6209 16th Ave Brooklyn NY 11204-2702 Ph: (718) 234-0073 | Icl Healthcare Choices Inc 179 Jamaica Ave Brooklyn NY 11207-2049 Ph: (929) 267-5354 |
NPI Number | 1770011314 |
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Provider Enumeration Date | 05/26/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770011314 | NPI | - | NPPES |
02186390 | Medicaid | NY | |
W86751 | Other | NY | PART B |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7001299R (New York) | Primary |
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