MEDICARE: LEAP FORWARD INC

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	251B00000X	Case Management Agency
2	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1407715931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEAP FORWARD INC

Provider Business Mailing Address
First Line	:	4502 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-6625
Country	:	US
Telephone Number	:	646-772-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	4502 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-6625
Country	:	US
Telephone Number	:	646-772-7900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOEL GROSS
Credential	:
Telephone Number	:	646-772-7900

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “LEAP FORWARD INC ” Practice Location

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