Organization
MESIDOR EARLY INTERVENTION LLC
Active
Other names
Micheline Mesidor
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELINE MESIDOR MS (SPECIAL INSTRUCTOR)
(347) 410-3248
Entity
Organization
Contact information
Practice address
7916 147TH ST APT C8, FLUSHING, NY 11367-3766
(347) 410-3248
Mailing address
7916 147TH ST APT C8, FLUSHING, NY 11367-3766
(347) 410-3248
(347) 960-7625
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
328194
NY
Other
Enumeration date
02/24/2018
Last updated
08/17/2018
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