Organization
PEDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GODZICH (SPECIAL EDUCATION TEACHER)
(716) 830-7602
Entity
Organization
Contact information
Practice address
4242 RIDGE LEA RD STE 2, AMHERST, NY 14226-5122
(716) 819-2400
Mailing address
58 FAIRELM LN, CHEEKTOWAGA, NY 14227-1356
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
171028475
NY
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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