Healthcare Provider Details

I. General information

NPI: 1992981625
Provider Name (Legal Business Name): ANDERSON FOUNDATION FOR AUTISM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4885 ROUTE 9
STAATSBURG NY
12580
US

IV. Provider business mailing address

PO BOX 367
STAATSBURG NY
12580-0367
US

V. Phone/Fax

Practice location:
  • Phone: 845-889-4034
  • Fax: 845-889-4623
Mailing address:
  • Phone: 845-889-4034
  • Fax: 845-889-4623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TINA CHIRICO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 845-889-4034