Organization
GMMD CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERDA M ETIENNE VAVAL (SPECIAL EDUCATION, TSHH)
(516) 263-9905
Entity
Organization
Contact information
Practice address
310 NASSAU AVE, FREEPORT, NY 11520-6119
(516) 263-9905
Mailing address
310 NASSAU AVE, FREEPORT, NY 11520-6119
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
CERTIFIED
NY
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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