Healthcare Provider Details

I. General information

NPI: 1588509152
Provider Name (Legal Business Name): SMILE AND LEARN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 ELWOOD AVE
STATEN ISLAND NY
10314-6020
US

IV. Provider business mailing address

59 ELWOOD AVE
STATEN ISLAND NY
10314-6020
US

V. Phone/Fax

Practice location:
  • Phone: 917-969-3814
  • Fax:
Mailing address:
  • Phone: 917-969-3814
  • 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: MRS. IRINA BRAYLOVSKY
Title or Position: ORGANIZER/OFFICER
Credential:
Phone: 917-969-3814