MEDICARE: O.W.L. ACADEMY, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)		NY
2	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1194025007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O.W.L. ACADEMY, LLP

Provider Business Mailing Address
First Line	:	258 BEACH 139TH ST
Second Line	:
City	:	BELLE HARBOR
State	:	NY
Zip	:	11694-1214
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	258 BEACH 139TH ST
Second Line	:
City	:	BELLE HARBOR
State	:	NY
Zip	:	11694-1214
Country	:	US
Telephone Number	:	347-307-2863
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. LAURA LEVY-WINIARSKY
Credential	:	MSW
Telephone Number	:	347-307-2863

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	10/25/2010

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