| NPI | 1295218592 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARIBEL LINO Special Instruction 917-406-3243  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 174400000X Specialist | 
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency | 
| Enumeration Date | 2018-09-12 | 
| Last Update Date | 2018-09-13 |