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General NPI Number Information
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NPI Number | 1972758027
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Entity Type | Organization
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Legal Business Name | JARED & JAEDEN MAKING A DIFFERENCE LLC
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 7408 OVERHILL DR
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City | POMONA
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State | NY
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Zip | 10970-3805
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Country | US
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Telephone | 516-903-2081
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Fax |
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Provider Business Mailing Address
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Address Line | 7408 OVERHILL DR
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City | POMONA
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State | NY
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Zip | 10970-3805
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Country | US
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Telephone | 516-903-2081
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Fax |
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Authorized Official
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Title or Position | LMSW
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Name | SHARON NUNEZ
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Credential |
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Telephone | 516-903-2081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 049877-1
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License Number State | NY
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