Provider Demographics
NPI:1306387097
Name:AIDAN & ROSS, INC
Entity Type:Organization
Organization Name:AIDAN & ROSS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:347-512-8093
Mailing Address - Street 1:109 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5568
Mailing Address - Country:US
Mailing Address - Phone:347-512-8093
Mailing Address - Fax:516-804-3418
Practice Address - Street 1:109 MELROSE AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5568
Practice Address - Country:US
Practice Address - Phone:347-512-8093
Practice Address - Fax:516-804-3418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068787-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency