Provider Demographics
NPI:1407160211
Name:MILESTONE EARLY INTERVENTION CENTER
Entity Type:Organization
Organization Name:MILESTONE EARLY INTERVENTION CENTER
Other - Org Name:MILESTONE SCHOOL FOR CHILD DEVELOPMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-246-1470
Mailing Address - Street 1:15 HANOVER PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5839
Mailing Address - Country:US
Mailing Address - Phone:718-246-1470
Mailing Address - Fax:718-246-1481
Practice Address - Street 1:15 HANOVER PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5839
Practice Address - Country:US
Practice Address - Phone:718-246-1470
Practice Address - Fax:718-246-1481
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILESTONE SCHOOL FOR CHILD DEVELOPMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency