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Organization

INNOBA ABA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MIKYEONG KIM ED.D (DIRECTOR)
(718) 819-8828
Entity
Organization

Contact information

Practice address
5402 217TH ST, BAYSIDE HILLS, NY 11364-1429
(718) 819-8828
Mailing address
5143 BELL BLVD, BAYSIDE HILLS, NY 11364-1225

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
01/25/2023
Last updated
01/25/2023
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