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General NPI Number Information
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NPI Number | 1235585290
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Entity Type | Organization
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Legal Business Name | DAVID S. ERDOS, LLC
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 1610 HEREFORD RD
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City | HEWLETT
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State | NY
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Zip | 11557-1804
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Country | US
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Telephone | 917-691-7416
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Fax | 516-791-3444
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Provider Business Mailing Address
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Address Line | 1610 HEREFORD RD
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City | HEWLETT
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State | NY
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Zip | 11557-1804
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Country | US
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Telephone | 917-691-7416
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Fax | 516-791-3444
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID S. ERDOS
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Credential |
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Telephone | 917-691-7416
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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 | 012143
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License Number State | NY
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