| NPI | 1992190565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH D JACOBS Clinical Director 718-503-4551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: CA I-14-4740) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |