Healthcare Provider Details

I. General information

NPI: 1033572706
Provider Name (Legal Business Name): KIDS FIRST SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 WIDMAN CT UNIT 201
SPRING VALLEY NY
10977-8305
US

IV. Provider business mailing address

23 WIDMAN CT UNIT 201
SPRING VALLEY NY
10977-8305
US

V. Phone/Fax

Practice location:
  • Phone: 845-587-0928
  • Fax:
Mailing address:
  • Phone: 845-587-0928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: SHRAGA GOLD
Title or Position: PRESIDENT
Credential:
Phone: 845-270-5296