Individual
MRS. LISA GEFEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ED.
Contact information
Practice address
1413 BAY 28TH ST, FAR ROCKAWAY, NY 11691-1703
(718) 868-3130
(718) 868-3130
Mailing address
1413 BAY 28TH ST, FAR ROCKAWAY, NY 11691-1703
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
481347041
NY
Other
Enumeration date
10/21/2012
Last updated
10/21/2012
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