| NPI | 1265158307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALINA KHAYRULLINA Credentialing Specialist 718-934-6714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2023-04-10 |