Provider Demographics
NPI:1467085845
Name:PRIME KIDS, INC
Entity Type:Organization
Organization Name:PRIME KIDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIERTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NATANELOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-567-6987
Mailing Address - Street 1:7304 193RD ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1832
Mailing Address - Country:US
Mailing Address - Phone:917-567-6987
Mailing Address - Fax:
Practice Address - Street 1:7304 193RD ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1832
Practice Address - Country:US
Practice Address - Phone:917-567-6987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty