| Na | |
|
4023 Murdock Ave Bronx NY 10466-2322 | |
| (347) 886-0257 | |
| Not Available |
| Full Name | Na |
|---|---|
| Speciality | Early Intervention Provider Agency |
| Location | 4023 Murdock Ave, Bronx, New York |
| Authorized Official Name and Position | Beverley D Adjmul (PRESIDENT/) |
| Authorized Official Contact | 3478860257 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Na 4023 Murdock Ave Bronx NY 10466-2322 Ph: (347) 886-0257 | Na 4023 Murdock Ave Bronx NY 10466-2322 Ph: (347) 886-0257 |
| NPI Number | 1174100457 |
|---|---|
| Provider Enumeration Date | 03/24/2021 |
| Last Update Date | 08/23/2021 |
| Certification Date | 08/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174100457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Secondary |
| 252Y00000X | Early Intervention Provider Agency | () | Primary |
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