Healthcare Provider Details

I. General information

NPI: 1053552901
Provider Name (Legal Business Name): ASSOCIATION FOR CHILDREN WITH DOWN SYNDROME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 03/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 FERN PL
PLAINVIEW NY
11803-4725
US

IV. Provider business mailing address

4 FERN PL
PLAINVIEW NY
11803-4725
US

V. Phone/Fax

Practice location:
  • Phone: 516-933-4700
  • Fax: 516-933-9526
Mailing address:
  • Phone: 516-933-4700
  • Fax: 516-933-9526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number280504880006
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MICHAEL M SMITH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 516-933-4700