Provider Demographics
NPI:1093956567
Name:TARSIA, VANESSA (SPECIAL ED TEACHER)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:TARSIA
Suffix:
Gender:F
Credentials:SPECIAL ED TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 PEARSALL AVE
Mailing Address - Street 2:LONG ISLAND CENTER OF CHILD DEVELOPMENT
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516
Mailing Address - Country:US
Mailing Address - Phone:516-374-3261
Mailing Address - Fax:
Practice Address - Street 1:385 PEARSALL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1800
Practice Address - Country:US
Practice Address - Phone:516-374-3261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24539252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency