Provider Demographics
NPI:1205199015
Name:RENA GOLDMAN 7142 INC.
Entity Type:Organization
Organization Name:RENA GOLDMAN 7142 INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEC ED
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:917-293-3603
Mailing Address - Street 1:7142 147TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2017
Mailing Address - Country:US
Mailing Address - Phone:917-293-3603
Mailing Address - Fax:
Practice Address - Street 1:7142 147TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2017
Practice Address - Country:US
Practice Address - Phone:917-293-3603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency