=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255701413
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUNTER LEARNING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2015
-----------------------------------------------------
Last Update Date | 09/30/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13003 233RD ST
-----------------------------------------------------
City | ROSEDALE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11422-1224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-526-7379
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13003 233RD ST
-----------------------------------------------------
City | ROSEDALE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11422-1224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-526-7379
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MS. SHOSHONI NAKIA FULCHER
-----------------------------------------------------
Credential | MSED
-----------------------------------------------------
Telephone | 347-526-7379
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 798914
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------