Provider Demographics
NPI:1528327848
Name:NYC DEPT OF ED
Entity type:Organization
Organization Name:NYC DEPT OF ED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MA OTR/L
Authorized Official - Phone:212-722-6507
Mailing Address - Street 1:240 E 109TH ST
Mailing Address - Street 2:104C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3703
Mailing Address - Country:US
Mailing Address - Phone:212-722-6507
Mailing Address - Fax:
Practice Address - Street 1:240 E 109TH ST
Practice Address - Street 2:104C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3703
Practice Address - Country:US
Practice Address - Phone:212-722-6507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011515252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency