Provider Demographics
NPI:1114156528
Name:PRESCHOOL EARLY DEVELOPMENT AND SCREENING COMMITTEE OF ALBANY INC
Entity Type:Organization
Organization Name:PRESCHOOL EARLY DEVELOPMENT AND SCREENING COMMITTEE OF ALBANY INC
Other - Org Name:PEDS PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-782-7733
Mailing Address - Street 1:4 FRITZ BLVD.
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12110-4966
Mailing Address - Country:US
Mailing Address - Phone:518-218-7337
Mailing Address - Fax:518-218-0801
Practice Address - Street 1:4 FRITZ BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12110-4966
Practice Address - Country:US
Practice Address - Phone:518-218-7337
Practice Address - Fax:518-218-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency