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General NPI Number Information
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NPI Number | 1396817003
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Entity Type | Organization
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Legal Business Name | NORTHSIDE CENTER FOR CHILD DEVELOPMENT, INC.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1301 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10029-3119
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Country | US
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Telephone | 212-426-3400
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Fax | 212-410-7561
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Provider Business Mailing Address
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Address Line | 1301 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10029-3119
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Country | US
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Telephone | 212-426-3400
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Fax | 212-410-7561
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. THELMA DYE
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Credential | PHD.
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Telephone | 212-426-3410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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