Provider Demographics
NPI:1326457532
Name:PRIME TIME FOR KIDS
Entity Type:Organization
Organization Name:PRIME TIME FOR KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-639-2425
Mailing Address - Street 1:70 PHILLIPS HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4114
Practice Address - Country:US
Practice Address - Phone:845-639-2425
Practice Address - Fax:845-639-2433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency