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Organization
THERCARE
Active
Organization
THERCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE ROXANA GUTIERREZ (SERVICE COORDINATOR)
(718) 354-6543
Entity
Organization
Contact information
Practice address
2025 RICHMOND AVENUE, SUITE 200, STATEN ISLAND, NY 10314
(718) 698-1753
Mailing address
85 LOCUST AVENUE, STATEN ISLAND, NY 10306
(718) 354-6543
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
362694726
NY
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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