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General NPI Number Information
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NPI Number | 1770987646
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF EDUCATION
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 2230 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10037-2102
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Country | US
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Telephone | 212-690-5960
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Fax | 212-690-5959
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Provider Business Mailing Address
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Address Line | 2230 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10037-2102
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Country | US
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Telephone | 212-690-5960
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Fax | 212-690-5959
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Authorized Official
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Title or Position | SPECIAL EDUACTION TEACHER
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Name | MISS DAWN ATHENA ANDERSON
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Credential | M.S.ED.
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Telephone | 212-690-5960
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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 | 321844031
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License Number State | NY
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