Healthcare Provider Details

I. General information

NPI: 1720301286
Provider Name (Legal Business Name): STEP BY STEP INFANT DEVELOPMENT CENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 - 38 STREET
BROOKLYN NY
11219
US

IV. Provider business mailing address

1049 - 38 STREET
BROOKLYN NY
11219
US

V. Phone/Fax

Practice location:
  • Phone: 718-633-6666
  • Fax: 718-633-5331
Mailing address:
  • Phone: 718-633-6666
  • Fax: 718-633-5331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. SINAI HALBERSTAM
Title or Position: EXECUTIVE DIRECTOR
Credential: YR. YD.
Phone: 718-633-6666