| NPI | 1861756116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIELA PENA Compliance Coordinator 718-522-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 884497991) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: NY 884497991) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |