Individual
MARIA NIDEA PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20301 33RD AVE, BAYSIDE, NY 11361-1025
(347) 806-4173
Mailing address
20301 33RD AVE, BAYSIDE, NY 11361-1025
(347) 806-4173
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
008647-1
NY
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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