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Contact Information

79 MASADA III INC
1319 E 17TH ST
BROOKLYN, NY11230-6008
 Phone: 917-365-7535
 Fax: 718-336-0585
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Taxi

344600000X
Indicates primary specialty

NPI Profile & details for 79 MASADA III INC

NPI # 1316367568
LBN Legal business name 79 MASADA III INC
Authorized official ALEX STEFMAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/25/2014
Last updated 04/25/2014 - About 12 years ago
Identifiers
NY License # B01710
NY Medicaid 03792894
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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