Organization
INTERACTIVE THERAPY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI MOORE M.S. (SEIT)
(718) 679-6931
Entity
Organization
Contact information
Practice address
10500 SHORE FRONT PKWY APT 7K, ROCKAWAY PARK, NY 11694-2756
(718) 679-6931
Mailing address
10500 SHORE FRONT PKWY APT 7K, ROCKAWAY PARK, NY 11694-2756
(718) 679-6931
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2596980
NY
Other
Enumeration date
06/15/2014
Last updated
06/15/2014
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