# BLOSSOM KIDS THERAPY

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

## Provider details

- **NPI number:** 1700573235
- **Authorized official:** JENNIFER RYDER (AO)
- **Authorized official phone:** (917) 615-4817

## Contact information

- **Practice address:** 2156 E 66TH ST, BROOKLYN, NY 11234-6324
- **Practice address phone:** (646) 494-1128
- **Mailing address:** 9030 METROPOLITAN AVENUE, SUITE 3- \#1052, REGO PARK, NY 11374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/24/2023
- **Last updated:** 04/24/2023