# CRESTWOOD EARLY INTERVENTION LLC

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

## Provider details

- **NPI number:** 1952829988
- **Authorized official:** MARJORIE ELISE TIRSUN (DIRECTOR)
- **Authorized official phone:** (917) 796-8106

## Contact information

- **Practice address:** 10 CRESTWOOD DRIVE, PLAINVIEW, NY 11803
- **Practice address phone:** (917) 796-8106
- **Mailing address:** 10 CRESTWOOD DR, PLAINVIEW, NY 11803-6408

## Taxonomy

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

## Other

- **Enumeration date:** 08/30/2017
- **Last updated:** 08/30/2017