Organization
FIRST STEP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLGA NIZHNER (CEO)
(718) 332-0080
Entity
Organization
Contact information
Practice address
2955 BRIGHTON 4TH ST, BROOKLYN, NY 11235-8533
(718) 332-0080
(718) 332-3365
Mailing address
2955 BRIGHTON 4TH ST, BROOKLYN, NY 11235-8533
(718) 332-0080
(718) 332-3365
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
012594-1
NY
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11470785
CAQH
NY
Enumeration date
01/15/2007
Last updated
07/21/2022
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