Organization
ER INTERVENTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC ROBERTSON (CEO)
(917) 566-2656
Entity
Organization
Contact information
Practice address
13065 230TH ST, LAURELTON, NY 11413-1829
(917) 566-2656
Mailing address
13065 230TH ST, LAURELTON, NY 11413-1829
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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