Provider Demographics
NPI:1285862557
Name:NEW DIRECTIONS @ 710 ASSOCIATES, CSW, SLP, OT, PT, PLLC.
Entity Type:Organization
Organization Name:NEW DIRECTIONS @ 710 ASSOCIATES, CSW, SLP, OT, PT, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREZNAK-HONEYCHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-366-2944
Mailing Address - Street 1:710 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2505
Mailing Address - Country:US
Mailing Address - Phone:716-336-2944
Mailing Address - Fax:716-366-1667
Practice Address - Street 1:710 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2505
Practice Address - Country:US
Practice Address - Phone:716-336-2944
Practice Address - Fax:716-366-1667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0073851252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency