Provider Demographics
NPI:1407272321
Name:KIMBERCOY EARLY INTERVENTION SERVICES
Entity Type:Organization
Organization Name:KIMBERCOY EARLY INTERVENTION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-795-3690
Mailing Address - Street 1:555 EDGECOMBE AVE
Mailing Address - Street 2:14H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4406
Mailing Address - Country:US
Mailing Address - Phone:212-795-3690
Mailing Address - Fax:
Practice Address - Street 1:555 EDGECOMBE AVE
Practice Address - Street 2:14H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4406
Practice Address - Country:US
Practice Address - Phone:212-795-3690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty