| NPI | 1053854059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS DOLUB Director 929-371-2131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NY 023288) |
| 251B00000X Case Management | |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2017-01-23 |