MEDICARE: FIRST PRAISE KIDS SERVICES 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	252Y00000X	Early Intervention Provider Agency	691029	NY

General Provider Information

NPI Number	:	1467826834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST PRAISE KIDS SERVICES INC

Provider Business Mailing Address
First Line	:	1834 DOGWOOD DR
Second Line	:	YORKTOWN HEIGHTS
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-5602
Country	:	US
Telephone Number	:	914-434-3434
Fax Number	:

Provider Business Practice Location Address
First Line	:	1834 DOGWOOD DR
Second Line	:	YORKTOWN HEIGHTS
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-5602
Country	:	US
Telephone Number	:	914-434-3434
Fax Number	:

Authorized Official
Title or Position	:	SPECIAL EDUCATORE
Name	:	MS. SHERESE ANTOINETTE POW
Credential	:	MSED
Telephone Number	:	914-434-3434

Provider Enumeration Date	:	11/21/2015
Last Update Date	:	11/21/2015

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