# MESIDOR EARLY INTERVENTION LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Micheline Mesidor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003317017
- **Authorized official:** MICHELINE MESIDOR MS (SPECIAL INSTRUCTOR)
- **Authorized official phone:** (347) 410-3248

## Contact information

- **Practice address:** 7916 147TH ST APT C8, FLUSHING, NY 11367-3766
- **Practice address phone:** (347) 410-3248
- **Mailing address:** 7916 147TH ST APT C8, FLUSHING, NY 11367-3766
- **Mailing address phone:** (347) 410-3248
- **Mailing address fax:** (347) 960-7625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 328194 | NY | Yes |

## Other

- **Enumeration date:** 02/24/2018
- **Last updated:** 08/17/2018