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General NPI Number Information
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NPI Number | 1831630599
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Entity Type | Organization
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Legal Business Name | CHICHI THERAPEUTIC SERVICES INC
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 11821 QUEENS BLVD STE 418
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City | FOREST HILLS
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State | NY
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Zip | 11375-7208
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Country | US
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Telephone | 646-606-7288
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Fax |
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Provider Business Mailing Address
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Address Line | 11821 QUEENS BLVD STE 418
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City | FOREST HILLS
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State | NY
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Zip | 11375-7208
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Country | US
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Telephone | 646-606-7288
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CHINYELU LILY FAFOWORA
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Credential | MSED
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Telephone | 646-606-7288
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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 | 1114570
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License Number State | NY
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