# PEDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659707362
- **Authorized official:** AMY GODZICH (SPECIAL EDUCATION TEACHER)
- **Authorized official phone:** (716) 830-7602

## Contact information

- **Practice address:** 4242 RIDGE LEA RD STE 2, AMHERST, NY 14226-5122
- **Practice address phone:** (716) 819-2400
- **Mailing address:** 58 FAIRELM LN, CHEEKTOWAGA, NY 14227-1356

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 171028475 | NY | Yes |

## Other

- **Enumeration date:** 09/26/2013
- **Last updated:** 09/26/2013