Provider Demographics
NPI:1508011545
Name:CANARSIE EIP, INC.
Entity Type:Organization
Organization Name:CANARSIE EIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSCHENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:718-241-9211
Mailing Address - Street 1:1651 RALPH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3317
Mailing Address - Country:US
Mailing Address - Phone:718-241-9211
Mailing Address - Fax:
Practice Address - Street 1:1651 RALPH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3317
Practice Address - Country:US
Practice Address - Phone:718-241-9211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY38100252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency