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General NPI Number Information
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NPI Number | 1912512062
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Entity Type | Organization
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Legal Business Name | ELEONORA'S BRIGHT STARS INC
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 6260 99TH ST APT 1720
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City | REGO PARK
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State | NY
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Zip | 11374-6032
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Country | US
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Telephone | 347-361-1934
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Fax |
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Provider Business Mailing Address
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Address Line | 6260 99TH ST APT 1720
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City | REGO PARK
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State | NY
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Zip | 11374-6032
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Country | US
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Telephone | 347-361-1934
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Fax |
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Authorized Official
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Title or Position | SPECIAL EDUCATION TEACHER
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Name | ELEONORA AMINOVA
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Credential | MS
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Telephone | 347-361-1934
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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 |
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