Provider Demographics
NPI:1619517398
Name:CIRCLE ACADEMY
Entity type:Organization
Organization Name:CIRCLE ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ESFHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-698-7087
Mailing Address - Street 1:1650 UTOPIA PKWY
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3346
Mailing Address - Country:US
Mailing Address - Phone:516-698-7087
Mailing Address - Fax:718-229-5050
Practice Address - Street 1:1650 UTOPIA PKWY
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3346
Practice Address - Country:US
Practice Address - Phone:516-698-7087
Practice Address - Fax:718-229-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities