# DEPARTMENT OF EDUCATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 860 GRAND CONCOURSE APT 6L
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1861843179
- **Legal business name:** 860 GRAND CONCOURSE APT 6L
- **Authorized official:** DORLINE JEAN (SPEECH LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (917) 365-5013

## Contact information

- **Practice address:** 860 GRAND CONCOURSE APT 6L, BRONX, NY 10451-2818
- **Practice address phone:** (917) 365-5013
- **Mailing address:** 860 GRAND CONCOURSE APT 6L, BRONX, NY 10451-2818
- **Mailing address phone:** (917) 365-5013

## Taxonomy

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

## Other

- **Enumeration date:** 06/28/2016
- **Last updated:** 06/28/2016