Organization
PREMIER PROVIDERS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TASHANA F MOHABIR MS.CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(917) 669-1991
Entity
Organization
Contact information
Practice address
103 82ND RD, KEW GARDENS, NY 11415-1422
(917) 669-1991
(718) 360-8957
Mailing address
103 82ND RD, KEW GARDENS, NY 11415
(917) 669-1991
(718) 360-8957
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
0614371
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376793646
NPI PERSONAL NUMBER
NY
Enumeration date
12/07/2011
Last updated
12/07/2011
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