MEDICARE: JVJ EARLY INTERVENTION CORP

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	:	1760015671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JVJ EARLY INTERVENTION CORP

Provider Business Mailing Address
First Line	:	176 LITTLE NECK RD
Second Line	:
City	:	CENTERPORT
State	:	NY
Zip	:	11721-1144
Country	:	US
Telephone Number	:	516-404-1690
Fax Number	:

Provider Business Practice Location Address
First Line	:	176 LITTLE NECK RD
Second Line	:
City	:	CENTERPORT
State	:	NY
Zip	:	11721-1144
Country	:	US
Telephone Number	:	516-404-1690
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ROSE WYKA
Credential	:	MSED
Telephone Number	:	516-404-1690

Provider Enumeration Date	:	02/19/2020
Last Update Date	:	02/19/2020

Similar Medicare Providers

1770582637 — CENTERPORT FAMILY MEDICINE
Practice Location Address:

2 SILLS CT
CENTERPORT, NY
11721-1634

Practice Phone: 631-757-9500
Practice Fax: 631-757-2325

1497706014 — MRS. ALYSE FREDA-COLON LCSW
Practice Location Address:

410 E MAIN ST
CENTERPORT, NY
11721-1541

Practice Phone: 516-635-4848
Practice Fax:

1467489534 — MRS. KATE KANE LCSW
Practice Location Address:

203 PROSPECT RD
CENTERPORT, NY
11721-1149

Practice Phone: 631-239-5522
Practice Fax:

1538181664 — JOSHUA C FENDEL M.S. (SOCIAL WORK)
Practice Location Address:

301 E MAIN ST
CENTERPORT, NY
11721-1439

Practice Phone: 631-351-2940
Practice Fax: 631-824-9369

1235143249 — MARY BETH DENNISTON LCSW
Practice Location Address:

410 E MAIN ST
CENTERPORT, NY
11721-1541

Practice Phone: 631-262-0073
Practice Fax:

1689680308 — BARBARA DESIDERIO LCSW
Practice Location Address:

10 BENHAM CT
CENTERPORT, NY
11721-1507

Practice Phone: 631-239-5259
Practice Fax:

Directions to “JVJ EARLY INTERVENTION CORP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.