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General NPI Number Information
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NPI Number | 1124380571
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Entity Type | Organization
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Legal Business Name | FLUSHING HOSPITAL MEDICAL CENTER EARLY INTERVENTION PROGRAM
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Dates
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Enumeration Date | 06/12/2012
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Last Update Date | 06/12/2012
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Provider Practice Location Address
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Address Line | 13420 JAMAICA AVE
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City | JAMAICA
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State | NY
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Zip | 11418-2619
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Country | US
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Telephone | 718-206-8549
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Fax |
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Provider Business Mailing Address
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Address Line | 4559 156TH ST FL 1
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City | FLUSHING
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State | NY
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Zip | 11355-1724
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Country | US
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Telephone | 646-279-0711
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Fax |
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Authorized Official
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Title or Position | SERVICE CORDINATOR
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Name | MS. CAROLINE MARIE QUINONES
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Credential |
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Telephone | 718-206-8549
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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 |
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License Number State |
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