Healthcare Provider Details

I. General information

NPI: 1700937802
Provider Name (Legal Business Name): FIRST STEP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2955 BRIGHTON 4TH ST
BROOKLYN NY
11235-8533
US

IV. Provider business mailing address

2955 BRIGHTON 4TH ST
BROOKLYN NY
11235-8533
US

V. Phone/Fax

Practice location:
  • Phone: 718-332-0080
  • Fax: 718-332-3365
Mailing address:
  • Phone: 718-332-0080
  • Fax: 718-332-3365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number012594-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. OLGA NIZHNER
Title or Position: CEO
Credential:
Phone: 718-332-0080