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NPI Code Detail

MEDICARE: BUILDING BLOCKS LEARNING CENTER, LLC

MEDICARE: BUILDING BLOCKS LEARNING CENTER, 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
1252Y00000XEarly Intervention Provider Agency014074NY

General Provider Information

NPI Number : 1568607042
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUILDING BLOCKS LEARNING CENTER, LLC
Provider Business Mailing Address
First Line : 19 ROBINSON RD
Second Line :
City : CLINTON
State : NY
Zip : 13323-1418
Country : US
Telephone Number : 315-853-6090
Fax Number : 315-853-3190
Provider Business Practice Location Address
First Line : 19 ROBINSON RD
Second Line :
City : CLINTON
State : NY
Zip : 13323-1418
Country : US
Telephone Number : 315-853-6090
Fax Number : 315-853-3190
Authorized Official
Title or Position : SLP/DIRECTOR
Name : MRS. MICHELLE PULEO O'BRIEN
Credential : MS, CCC-SLP
Telephone Number : 315-853-6090
Provider Enumeration Date : 12/11/2008
Last Update Date : 07/18/2014

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Directions to “BUILDING BLOCKS LEARNING CENTER, LLC ” Practice Location

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