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NPI Code Detail

MEDICARE: 123 BABY TALKS DEVELOPMENTAL SERVICES LLC

MEDICARE: 123 BABY TALKS DEVELOPMENTAL SERVICES LLC
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
1251B00000XCase Management Agency
2252Y00000XEarly Intervention Provider Agency

General Provider Information

NPI Number : 1811459183
Entity Type Code : Organization
Provider Name (Legal Business Name) : 123 BABY TALKS DEVELOPMENTAL SERVICES LLC
Provider Business Mailing Address
First Line : 933 MORRIS PARK AVE
Second Line :
City : BRONX
State : NY
Zip : 10462-3711
Country : US
Telephone Number : 914-280-9210
Fax Number :
Provider Business Practice Location Address
First Line : 933 MORRIS PARK AVE
Second Line :
City : BRONX
State : NY
Zip : 10462-3711
Country : US
Telephone Number : 914-280-9210
Fax Number :
Authorized Official
Title or Position : CEO
Name : NIK BERISHA
Credential :
Telephone Number : 914-280-9210
Provider Enumeration Date : 04/04/2019
Last Update Date : 08/21/2019

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