Provider Demographics
NPI:1265012892
Name:ITSY BITSY INC
Entity Type:Organization
Organization Name:ITSY BITSY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, CEO, PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMENOVA
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:718-986-9830
Mailing Address - Street 1:16 FAIRLAWN LOOP
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-3509
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 FAIRLAWN LOOP
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-3509
Practice Address - Country:US
Practice Address - Phone:718-986-9830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management