Provider Demographics
NPI:1306203153
Name:SMILESTONES EARLY INTERVENTION INC
Entity Type:Organization
Organization Name:SMILESTONES EARLY INTERVENTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:347-406-2547
Mailing Address - Street 1:2825 CLAFLIN AVE
Mailing Address - Street 2:APT WA
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-2205
Mailing Address - Country:US
Mailing Address - Phone:347-406-2547
Mailing Address - Fax:
Practice Address - Street 1:2825 CLAFLIN AVE
Practice Address - Street 2:APT WA
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-2205
Practice Address - Country:US
Practice Address - Phone:347-406-2547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY830255141252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency