Healthcare Provider Details

I. General information

NPI: 1538083407
Provider Name (Legal Business Name): GUIDING STEPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SURF AVE APT 22M
BROOKLYN NY
11224-3547
US

IV. Provider business mailing address

979 ULSTER HEIGHTS RD
ELLENVILLE NY
12428-5746
US

V. Phone/Fax

Practice location:
  • Phone: 718-300-0600
  • Fax:
Mailing address:
  • Phone: 718-300-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. DMITRY ROTH
Title or Position: OWNER/CEO
Credential: SPECIALIST
Phone: 718-300-0600