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General NPI Number Information
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NPI Number | 1972950038
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Entity Type | Organization
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Legal Business Name | CHILDRENS LINK EARLY INTERVENTION
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | 615 W 143RD ST SUITE 41
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City | NEW YORK
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State | NY
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Zip | 10031-5909
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Country | US
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Telephone | 718-710-1465
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Fax |
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Provider Business Mailing Address
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Address Line | 615 W 143RD ST SUITE 41
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City | NEW YORK
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State | NY
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Zip | 10031-5909
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Country | US
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Telephone | 718-710-1465
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ROSA MARINA RODRIGUEZ
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Credential | MASTERS
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Telephone | 718-710-1465
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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 | 1212357
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License Number State | NY
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