| Reborn For New Life Llc | |
|
400 Liberty Ave Brooklyn NY 11207-3032 | |
| (646) 251-1400 | |
| Not Available |
| Full Name | Reborn For New Life Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 400 Liberty Ave, Brooklyn, New York |
| Authorized Official Name and Position | Wilkins Williams (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9175530982 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reborn For New Life Llc 400 Liberty Ave Brooklyn NY 11207-3032 Ph: (646) 251-1400 | Reborn For New Life Llc 400 Liberty Ave Brooklyn NY 11207-3032 Ph: (646) 251-1400 |
| NPI Number | 1598181513 |
|---|---|
| Provider Enumeration Date | 03/14/2014 |
| Last Update Date | 04/01/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598181513 | NPI | - | NPPES |
| 150211831 | Other | NY | OASAS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 150211831 (New York) | Primary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
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