Provider Demographics
NPI:1194205393
Name:NY CENTER FOR AUTISM TREATMENT
Entity Type:Organization
Organization Name:NY CENTER FOR AUTISM TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:IAMINA
Authorized Official - Middle Name:DIANA
Authorized Official - Last Name:STOIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:347-282-3775
Mailing Address - Street 1:20 JOVAL CT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 JOVAL CT
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5950
Practice Address - Country:US
Practice Address - Phone:718-484-9219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)