Organization
EXCEL-ABILITIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE JO PETHERICK (CEO)
(516) 690-3681
Entity
Organization
Contact information
Practice address
1 GEORGE ST, GLEN COVE, NY 11542-1813
(516) 690-3681
Mailing address
1 GEORGE ST, GLEN COVE, NY 11542-1813
(516) 690-3681
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
010022-1
NY
Other
Enumeration date
11/15/2008
Last updated
11/15/2008
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