MEDICARE: RIZING KIDZ LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1184260127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIZING KIDZ LLC

Provider Business Mailing Address
First Line	:	1976 E 9TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3242
Country	:	US
Telephone Number	:	917-392-4009
Fax Number	:

Provider Business Practice Location Address
First Line	:	1976 E 9TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3242
Country	:	US
Telephone Number	:	917-392-4009
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SYDELL GUIGUI
Credential	:	MSED
Telephone Number	:	917-392-4009

Provider Enumeration Date	:	11/25/2019
Last Update Date	:	08/27/2020

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Directions to “RIZING KIDZ LLC ” Practice Location

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