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General NPI Number Information
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NPI Number | 1356656052
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Entity Type | Organization
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Legal Business Name | ROSALIE MENDUNI, DBA, EAST NORWICH THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 08/18/2010
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Provider Practice Location Address
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Address Line | 898 OYSTER BAY RD
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City | EAST NORWICH
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State | NY
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Zip | 11732-1051
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Country | US
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Telephone | 516-677-1994
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CALVERT DR
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City | SYOSSET
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State | NY
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Zip | 11791-2905
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Country | US
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Telephone | 516-677-1994
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Fax |
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Authorized Official
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Title or Position | OTR/L
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Name | MRS. ROSALIE MENDUNI
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Credential | M.A.
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Telephone | 516-677-1994
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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 | 003176-1
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License Number State | NY
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