=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932476603
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LITTLE TALKERS CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2011
-----------------------------------------------------
Last Update Date | 11/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3215 COURT ST
-----------------------------------------------------
City | YORKTOWN HEIGHTS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10598-2503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-299-0969
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3215 COURT ST
-----------------------------------------------------
City | YORKTOWN HEIGHTS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10598-2503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 17-299-0969
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. TATYANA YELEVICH-IZNYUK
-----------------------------------------------------
Credential | MA, SI, TSHH
-----------------------------------------------------
Telephone | 917-299-0969
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 394379031
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------