Organization
DIFFO DS CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRA FELIZ MS SP. ED (SPECIAL ED TEACHER)
(718) 775-5096
Entity
Organization
Contact information
Practice address
3020 LAWTON AVE PH, BRONX, NY 10465-3425
(718) 775-5096
Mailing address
3020 LAWTON AVE PH, BRONX, NY 10465-3425
(718) 775-5096
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194088138
—
NY
Enumeration date
08/01/2021
Last updated
08/01/2021
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