THE THREE COPTIC BROTHERS CORP. - NPI NUMBER 1033533542

Summary

Provider Name: THE THREE COPTIC BROTHERS CORP.

NPI Number: 1033533542

Clasification: Clinic/Center (261QA0600X)

Specialization: Adult Day Care

Address:
2297 CONEY ISLAND AVE
BROOKLYN, NY
ZIP 11223

Phone Number: (718) 645-4500



Detailed Information

THE THREE COPTIC BROTHERS CORP. is an adult day care clinic/center in Brooklyn, NY. The assigned NPI number for this provider is 1033533542 and is registered as an organization entity type.

The provider's business address is:

2297 CONEY ISLAND AVE
BROOKLYN, NY
ZIP 11223-337
Phone: (718) 645-4500
Fax: (718) 645-4505

The provider's authorized official is Saleh Nasef .
The authorized official title is Director and has the following contact phone number (718) 645-4500.

The enumeration date for this NPI number is 2/5/2014 and was last updated on 2/5/2014.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QA0600X Clinic/Center Adult Day Care Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1033533542 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name THE THREE COPTIC BROTHERS CORP. The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 2297 CONEY ISLAND AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name BROOKLYN The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name NY The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 112233337 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 7186454500 The telephone number associated with the location address of the provider being identified.
11 Provider Business Practice Location Address Fax Number 7186454505 The fax number associated with the location address of the provider being identified.
12 Provider Enumeration Date 2/5/2014 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 2/5/2014 The date that a record was last updated or changed.
14 Authorized Official Last Name NASEF The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name SALEH The first name of the authorized official.
16 Authorized Official Title or Position DIRECTOR The title or position of the authorized official.
17 Authorized Official Telephone Number 7186454500 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 261QA0600X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Is Organization Subpart N
21 Authorized Official Credential Text MLSW

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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