Organization
MINDS WITH PURPOSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIKTOR GRINBERG MBA (PROGRAM DIRECTOR)
(646) 464-4884
Entity
Organization
Contact information
Practice address
1110 SOUTH AVE, STATEN ISLAND, NY 10314-3403
(718) 698-6905
Mailing address
4 ROMER RD, STATEN ISLAND, NY 10304-1227
(646) 464-4884
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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