| NPI | 1780983650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRIAM C. MOORE President / Director 631-543-6765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY PhysTherapy-004015) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 252Y00000X Early Intervention Provider Agency (Licence: Occupational Therapy) | |
| 252Y00000X Early Intervention Provider Agency (Licence: Speech Therapy) | |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |