Healthcare Provider Details

I. General information

NPI: 1194086272
Provider Name (Legal Business Name): EARLY CHILDHOOD ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W END AVE
NEW YORK NY
10025-3533
US

IV. Provider business mailing address

910 W END AVE
NEW YORK NY
10025-3533
US

V. Phone/Fax

Practice location:
  • Phone: 212-662-9200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS KATHLEEN BOATWRIGHT
Title or Position: SERVICE COORDINATOR
Credential:
Phone: 212-662-9200