Provider Demographics
NPI:1962964288
Name:THE ABRAHAM MANBERG ORGANIZATION CORPORATION
Entity type:Organization
Organization Name:THE ABRAHAM MANBERG ORGANIZATION CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OFFEIBEA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANTEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-607-9149
Mailing Address - Street 1:PO BOX 280013
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-0013
Mailing Address - Country:US
Mailing Address - Phone:929-624-2136
Mailing Address - Fax:929-600-5678
Practice Address - Street 1:21110 99TH AVENUE
Practice Address - Street 2:A
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-1142
Practice Address - Country:US
Practice Address - Phone:929-624-2136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care