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General NPI Number Information
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NPI Number | 1598119745
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Entity Type | Organization
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Legal Business Name | SUNSHINE DEVELOPMENTAL SPECIALISTS, INC
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/14/2016
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Provider Practice Location Address
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Address Line | 2701 GRAND CONCOURSE APT 5H
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City | BRONX
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State | NY
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Zip | 10468-3708
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Country | US
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Telephone | 917-873-3669
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Fax | 718-559-6439
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Provider Business Mailing Address
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Address Line | 2701 GRAND CONCOURSE APT 5H
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City | BRONX
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State | NY
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Zip | 10468-3708
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Country | US
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Telephone | 917-873-3669
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Fax | 718-559-6439
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Authorized Official
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Title or Position | SPECIAL EDUCATION TEACHER
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Name | KERLYS FELIZ
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Credential | M.S. ED
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Telephone | 917-873-3669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1155331
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 1155331
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License Number State | NY
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