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Organization

PRIME KIDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SOFIYA RAFAILOVA (OWNER)
(718) 880-1204
Entity
Organization

Contact information

Practice address
15044 78TH AVE, FLUSHING, NY 11367-3437
(718) 880-1204
(718) 880-1204
Mailing address
15044 78TH AVE, FLUSHING, NY 11367-3437
(718) 880-1204
(718) 880-1204

Taxonomy

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

Other

Enumeration date
01/13/2014
Last updated
01/13/2014
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