Organization
FUNCTIONAL LIFE ACHIEVEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS PARISI-ELLIS (ED SUPERVISOR)
(718) 886-6456
Entity
Organization
Contact information
Practice address
161 MADISON AVE, 2ND FLOOR, NEW YORK, NY 10016-5421
(212) 683-8905
Mailing address
161 MADISON AVE, 2ND FLOOR, NEW YORK, NY 10016-5421
(212) 683-8905
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2305418
NY
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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