Provider Demographics
NPI:1003122839
Name:THERAPEUTIC IMPRINTS, INC.
Entity Type:Organization
Organization Name:THERAPEUTIC IMPRINTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MS/OTR/L
Authorized Official - Phone:718-409-6977
Mailing Address - Street 1:7 ODELL PLZ
Mailing Address - Street 2:SUITE 130, #1123
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-7501
Mailing Address - Country:US
Mailing Address - Phone:718-409-6977
Mailing Address - Fax:718-409-6946
Practice Address - Street 1:7 ODELL PLZ
Practice Address - Street 2:SUITE 130 #1123
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-7501
Practice Address - Country:US
Practice Address - Phone:718-409-6977
Practice Address - Fax:718-409-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3046252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency