Provider Demographics
NPI:1164214276
Name:DUTCHIE STARS LLC
Entity type:Organization
Organization Name:DUTCHIE STARS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL INSTRUCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:V
Authorized Official - Last Name:MORTIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:917-808-5856
Mailing Address - Street 1:2 HILLIARD AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1232
Mailing Address - Country:US
Mailing Address - Phone:917-808-5856
Mailing Address - Fax:
Practice Address - Street 1:2 HILLIARD AVE APT 1
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1232
Practice Address - Country:US
Practice Address - Phone:917-808-5856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency