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General NPI Number Information
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NPI Number | 1417286444
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC ASSESSMENT, INC.
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 1641 3RD AVE 29DE
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City | NEW YORK
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State | NY
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Zip | 10128-3623
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Country | US
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Telephone | 718-734-1764
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Fax | 718-734-1764
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Provider Business Mailing Address
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Address Line | 1641 3RD AVE 29DE
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City | NEW YORK
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State | NY
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Zip | 10128-3623
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Country | US
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Telephone | 718-734-1764
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Fax | 718-734-1764
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Authorized Official
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Title or Position | COO
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Name | MR. RANDOLPH CABAN
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Credential | SPECIAL EDUCATION
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Telephone | 718-734-1764
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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 | 11302
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License Number State | NY
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