Provider Demographics
NPI:1215974183
Name:BGR SERVICES INC.
Entity type:Organization
Organization Name:BGR SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DELBRUNE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:718-328-2605
Mailing Address - Street 1:925 BROWERS POINT BR
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1735
Mailing Address - Country:US
Mailing Address - Phone:516-295-0817
Mailing Address - Fax:516-295-0817
Practice Address - Street 1:7 DEBEVOISE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4101
Practice Address - Country:US
Practice Address - Phone:718-388-5950
Practice Address - Fax:718-388-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060811567101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02679454Medicaid