Organization · NPI-2

Asoa LLC Dba Phullon Care Providers

Specialist/Technologist, Other · Brooklyn, NY

NPI number1609317460
StatusActive
Last updated in NPPESMay 17, 2024

Details

NPI
1609317460
Entity type
Organization (NPI-2)
Legal business name
Asoa LLC Dba Phullon Care Providers
Organization subpart
No
Enumeration date
Mar 13, 2017
Certification date
May 17, 2024
Last updated
May 17, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246Z00000X Specialist/Technologist, Other––Yes

Practice location

2182 Pitkin Ave
Brooklyn, NY 11207-3613

Phone 718-215-4011 · Fax 718-215-4042

Mailing address

2182 Pitkin Ave
Brooklyn, NY 11207-3613

Phone 718-215-4011 · Fax 718-215-4042

Authorized official

Joy Langford
President
7185719177

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Other Specialist/Technologist, Other providers in Brooklyn, NY