Healthcare Provider Details

I. General information

NPI: 1285862557
Provider Name (Legal Business Name): NEW DIRECTIONS @ 710 ASSOCIATES, CSW, SLP, OT, PT, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 CENTRAL AVE
DUNKIRK NY
14048-2505
US

IV. Provider business mailing address

710 CENTRAL AVE
DUNKIRK NY
14048-2505
US

V. Phone/Fax

Practice location:
  • Phone: 716-336-2944
  • Fax: 716-366-1667
Mailing address:
  • Phone: 716-336-2944
  • Fax: 716-366-1667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number0073851
License Number StateNY

VIII. Authorized Official

Name: SUSAN BREZNAK-HONEYCHURCH
Title or Position: CLINICAL COORDINATOR
Credential: PT
Phone: 716-366-2944