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Organization

ILLIASSA INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMBA SINGHATEH (PRESIDENT)
(646) 270-5436
Entity
Organization

Contact information

Practice address
2139 WASHINGTON AVE, BRONX, NY 10457-2553
(646) 270-5436
(718) 901-3739
Mailing address
2139 WASHINGTON AVE, BRONX, NY 10457-2553
(646) 270-5436
(718) 901-3739

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
751806
NY

Other

Enumeration date
03/07/2016
Last updated
03/07/2016
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