Provider Demographics
NPI:1588378723
Name:THE THINKUBATOR, INC.
Entity type:Organization
Organization Name:THE THINKUBATOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:347-468-6621
Mailing Address - Street 1:128 ALEXANDER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-4455
Mailing Address - Country:US
Mailing Address - Phone:917-631-9410
Mailing Address - Fax:
Practice Address - Street 1:128 ALEXANDER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-4455
Practice Address - Country:US
Practice Address - Phone:917-631-9410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251300000XAgenciesLocal Education Agency (LEA)
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5784218OtherNYS CORPORATION REGISTRATION