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General NPI Number Information
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NPI Number | 1003288176
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Entity Type | Organization
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Legal Business Name | LITTLE ONES FIRST LLC
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 15026 20TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357-3133
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Country | US
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Telephone | 917-279-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 15026 20TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357-3133
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Country | US
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Telephone | 917-279-9595
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. GUSTAVO D ZYLBERBERG
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Credential | DPT
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Telephone | 917-279-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 031271
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License Number State | NY
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