Healthcare Provider Details
I. General information
NPI: 1306431333
Provider Name (Legal Business Name): LITTLE GIANTS CHILD CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2021
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4502 13TH AVE BSMT
BROOKLYN NY
11219-2018
US
IV. Provider business mailing address
1447 48TH ST APT 1
BROOKLYN NY
11219-3252
US
V. Phone/Fax
- Phone: 718-577-8486
- Fax:
- Phone: 347-668-0704
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SIMCHA
GARFINKEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-577-8486