Organization
PERSONAL QUALITY CARE MANUAL PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYNAT GLAZ (PRESIDENT)
(917) 748-9332
Entity
Organization
Contact information
Practice address
58 VALLEY GREENS DR, VALLEY STREAM, NY 11581-3635
(917) 748-9332
Mailing address
58 VALLEY GREENS DR, VALLEY STREAM, NY 11581-3635
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
016625
NY
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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