Provider Demographics
NPI:1033658661
Name:CHILDREN'S EARLY INTERVENTION DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:CHILDREN'S EARLY INTERVENTION DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUNDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-267-9070
Mailing Address - Street 1:1072 REMSEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3452
Mailing Address - Country:US
Mailing Address - Phone:347-267-9070
Mailing Address - Fax:
Practice Address - Street 1:1072 REMSEN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3452
Practice Address - Country:US
Practice Address - Phone:347-267-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency