Individual
TONETTE EARL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SERVICE COORDINATOR
Contact information
Practice address
3140B E TREMONT AVE, BRONX, NY 10461-5706
(718) 239-4147
Mailing address
37 WILLIAMS AVE, SPRING VALLEY, NY 10977-3005
(917) 741-8586
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
252Y00000X
EARLY INTERVENTION PROVIDER
NY
05
—
25Y00000X
—
NY
Enumeration date
01/29/2018
Last updated
01/29/2018
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