Provider Demographics
NPI:1407257900
Name:NYSARC - ROCKLAND COUNTY CHAPTER
Entity Type:Organization
Organization Name:NYSARC - ROCKLAND COUNTY CHAPTER
Other - Org Name:PRIME TIME FOR KIDS
Other - Org Type:Doing Business As
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:845-639-2425
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:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NYSARC ROCKLAND COUNTY CHAPTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY74748513252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency