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General NPI Number Information
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NPI Number | 1659633071
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Entity Type | Organization
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Legal Business Name | THERACARE
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Dates
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Enumeration Date | 06/12/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 20 CEDAR ST
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5247
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Country | US
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Telephone | 914-576-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 71 HEIGHTS DR
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City | YONKERS
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State | NY
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Zip | 10710-2401
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Country | US
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Telephone | 914-439-3785
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Fax |
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Authorized Official
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Title or Position | SPECIAL ED TEACHER
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Name | MICHELLE BANOME
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Credential |
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Telephone | 914-439-3785
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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 |
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License Number State | NY
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