| NPI | 1861214744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENA SHMAVONYAN CEO 347-445-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-12-11 |