Healthcare Provider Details

I. General information

NPI: 1003744343
Provider Name (Legal Business Name): MAXIMIZING EARLY DEVELOPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLUB DR
ROSLYN HEIGHTS NY
11577-2601
US

IV. Provider business mailing address

1 CLUB DR
ROSLYN HEIGHTS NY
11577-2601
US

V. Phone/Fax

Practice location:
  • Phone: 718-865-7375
  • Fax:
Mailing address:
  • Phone: 718-865-7375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JULIE A SHIMUNOV
Title or Position: SPECIAL INSTRUCTION
Credential: MSED
Phone: 718-865-7375