Provider Demographics
NPI:1356795033
Name:IDEAL CONNECTIONS ARE NOW, INC.
Entity type:Organization
Organization Name:IDEAL CONNECTIONS ARE NOW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PETULA
Authorized Official - Middle Name:SHERYL-ANN
Authorized Official - Last Name:SQUIRES
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:929-355-7557
Mailing Address - Street 1:1479 E 98TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5321
Mailing Address - Country:US
Mailing Address - Phone:929-355-7557
Mailing Address - Fax:866-679-7318
Practice Address - Street 1:1479 E 98TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5321
Practice Address - Country:US
Practice Address - Phone:929-355-7557
Practice Address - Fax:866-679-7318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1683208252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency