Organization
DEPARTMENT OF EDUCATION
Active
Parent organization
860 GRAND CONCOURSE APT 6L
Organization subpart
Yes
Provider details
NPI number
Legal business name
860 GRAND CONCOURSE APT 6L
Authorized official
DORLINE JEAN (SPEECH LANGUAGE PATHOLOGIST)
(917) 365-5013
Entity
Organization
Contact information
Practice address
860 GRAND CONCOURSE APT 6L, BRONX, NY 10451-2818
(917) 365-5013
Mailing address
860 GRAND CONCOURSE APT 6L, BRONX, NY 10451-2818
(917) 365-5013
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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