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General NPI Number Information
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NPI Number | 1043527237
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Entity Type | Organization
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Legal Business Name | EARLY CHILDHOOD INTERVENTION SERVICES, PLLC
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 14459 176TH ST
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City | JAMAICA
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State | NY
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Zip | 11434-4932
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Country | US
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Telephone | 718-344-4508
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Fax |
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Provider Business Mailing Address
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Address Line | 14459 176TH ST
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City | JAMAICA
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State | NY
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Zip | 11434-4932
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Country | US
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Telephone | 718-344-4508
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. PAULA SIMS
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Credential | MS CCC-SLP
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Telephone | 718-977-0110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | O17O19
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License Number State | NY
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