Healthcare Provider Details

I. General information

NPI: 1518879584
Provider Name (Legal Business Name): TMC ABA CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 DONGAN HILLS AVE
STATEN ISLAND NY
10305-3337
US

IV. Provider business mailing address

564 DONGAN HILLS AVE
STATEN ISLAND NY
10305-3337
US

V. Phone/Fax

Practice location:
  • Phone: 917-257-2776
  • Fax:
Mailing address:
  • Phone: 917-257-2776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TAMARA CHERNYAK
Title or Position: SPECIAL ED TEACHER
Credential: MS ED
Phone: 917-257-2776