Provider Demographics
NPI:1215568332
Name:EI DAWNS WAY
Entity Type:Organization
Organization Name:EI DAWNS WAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL INSTRUCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:ATHENA
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:845-800-8919
Mailing Address - Street 1:41 MAYER DR PH
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-3349
Mailing Address - Country:US
Mailing Address - Phone:845-800-8919
Mailing Address - Fax:
Practice Address - Street 1:41 MAYER DR PH
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-3349
Practice Address - Country:US
Practice Address - Phone:845-800-8919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty