Provider Demographics
NPI:1366260846
Name:COMMUNITY DEVELOPMENT OF ASIAN AMERICAN
Entity type:Organization
Organization Name:COMMUNITY DEVELOPMENT OF ASIAN AMERICAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NUSRATH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-246-5905
Mailing Address - Street 1:1983 MARCUS AVE STE C106
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2000
Mailing Address - Country:US
Mailing Address - Phone:646-246-5905
Mailing Address - Fax:516-407-5285
Practice Address - Street 1:1983 MARCUS AVE STE C106
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2000
Practice Address - Country:US
Practice Address - Phone:646-246-5905
Practice Address - Fax:516-407-5285
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY DEVELOPMENT OF ASIAN AMERICAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)