| NPI | 1477049807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA FAY ITKIN Otr/L 917-696-2478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 019938-1) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: NY 019938-1) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |