Organization
FIRSTSTEP EARLY INTERVENTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIRON SHAMALOV MSED (BEHAVIORAL THERAPIST)
(347) 476-4339
Entity
Organization
Contact information
Practice address
7469 220TH ST APT 1B, BAYSIDE, NY 11364
Mailing address
7469 220TH ST APT 1B, BAYSIDE, NY 11364-3015
(347) 476-4330
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252Y00000X
—
NY
Enumeration date
05/20/2019
Last updated
05/20/2019
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