Provider Demographics
NPI:1568836542
Name:AMMABA INC
Entity Type:Organization
Organization Name:AMMABA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE-HARILAL
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:212-470-8307
Mailing Address - Street 1:15020 27TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-1541
Mailing Address - Country:US
Mailing Address - Phone:212-470-8307
Mailing Address - Fax:
Practice Address - Street 1:15020 27TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1541
Practice Address - Country:US
Practice Address - Phone:212-470-8307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency