# PRODIGY OF NEW YORK, INC.

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

## Provider details

- **NPI number:** 1922510676
- **Authorized official:** MRS. TABATHA WILLIAMS BA, MS.ED (TEACHER/OWENER)
- **Authorized official phone:** (917) 804-3564

## Contact information

- **Practice address:** 75 W 238TH ST APT 1K, BRONX, NY 10463-4270
- **Practice address phone:** (917) 804-3564
- **Mailing address:** 75 W 238TH ST APT 1K, BRONX, NY 10463-4270
- **Mailing address phone:** (917) 804-3564

## Taxonomy

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

## Other

- **Enumeration date:** 11/02/2017
- **Last updated:** 11/02/2017