Organization
THERACARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS IRIS N/A FUENTES I MSED (SPECIAL INSTRUCTOR)
(718) 597-5558
Entity
Organization
Contact information
Practice address
2510 WESTCHESTER AVE, 102, BRONX, NY 10461-3512
(718) 597-5558
(718) 823-5494
Mailing address
2510 WESTCHESTER AVENUE, 102, NEW YORK CITY, NY 10461-3512
(718) 597-5558
(718) 823-5494
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
606668
NY
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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