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General NPI Number Information
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NPI Number | 1083953228
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Entity Type | Individual
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Provider Name | NINECHINE DESIRE-CHARLES M.S IN SPECIAL EDUCA
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Gender | Female
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Dates
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Enumeration Date | 02/07/2013
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Last Update Date | 02/07/2013
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Provider Practice Location Address
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Address Line | 3 PETERS LN
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City | SPRING VALLEY
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State | NY
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Zip | 10977-3122
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Country | US
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Telephone | 786-800-4476
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Fax |
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Provider Business Mailing Address
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Address Line | 3 PETERS LN
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City | SPRING VALLEY
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State | NY
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Zip | 10977-3122
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Country | US
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Telephone | 786-800-4476
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1719137
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License Number State | NY
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