Organization
BLAZING JOURNEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANINE MARTIN (DIRECTOR)
(718) 749-2849
Entity
Organization
Contact information
Practice address
22757 113TH DR, QUEENS VILLAGE, NY 11429-2722
(718) 749-2849
Mailing address
22757 113TH DR, QUEENS VILLAGE, NY 11429-2722
(718) 749-2849
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
05/27/2019
Last updated
05/27/2019
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