Provider Demographics
NPI:1366822678
Name:LJAZ INC
Entity Type:Organization
Organization Name:LJAZ INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYUBOV
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELTSER
Authorized Official - Suffix:
Authorized Official - Credentials:MSSPED
Authorized Official - Phone:718-415-5071
Mailing Address - Street 1:719 DESMOND CT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4201
Mailing Address - Country:US
Mailing Address - Phone:718-415-5071
Mailing Address - Fax:
Practice Address - Street 1:719 DESMOND CT
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4201
Practice Address - Country:US
Practice Address - Phone:718-415-5071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY891158252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency