Healthcare Provider Details

I. General information

NPI: 1134052350
Provider Name (Legal Business Name): AUNTIE'S EARLY ENRICHMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 HIGHLAND AVE
MIDDLETOWN NY
10940-4713
US

IV. Provider business mailing address

160 HIGHLAND AVE
MIDDLETOWN NY
10940-4713
US

V. Phone/Fax

Practice location:
  • Phone: 646-316-0203
  • Fax:
Mailing address:
  • Phone: 646-316-0203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TIASHA TAYLOR ROSA
Title or Position: EARLY INTERVENTION
Credential: MSED
Phone: 646-316-0203