Provider Demographics
NPI:1043572449
Name:YELED V YALDA
Entity Type:Organization
Organization Name:YELED V YALDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISABILITIES COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:JEANNETTE
Authorized Official - Last Name:JAIMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:718-720-0090
Mailing Address - Street 1:20 PARK HILL CIR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-3635
Mailing Address - Country:US
Mailing Address - Phone:718-720-0090
Mailing Address - Fax:718-720-0280
Practice Address - Street 1:20 PARK HILL CIR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-3635
Practice Address - Country:US
Practice Address - Phone:718-720-0090
Practice Address - Fax:718-720-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency