Organization
SELENA GRAD CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM GOROHOVSKY (OWNER)
(917) 969-4510
Entity
Organization
Contact information
Practice address
2222 E 26TH ST, BROOKLYN, NY 11229-4942
(917) 969-4510
Mailing address
2222 E 26TH ST, BROOKLYN, NY 11229-4942
(917) 969-4510
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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