Organization
TISH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANIA WATERS M.S. ED (TEACHER)
(917) 204-1762
Entity
Organization
Contact information
Practice address
54 FARRAGUT AVE, STATEN ISLAND, NY 10303-2903
(917) 204-1762
Mailing address
54 FARRAGUT AVE, STATEN ISLAND, NY 10303-2903
(917) 204-1762
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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