Provider Demographics
NPI:1578818522
Name:NEW YORK CHILD
Entity Type:Organization
Organization Name:NEW YORK CHILD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GWENNETH
Authorized Official - Middle Name:MEGAN
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-464-3139
Mailing Address - Street 1:10222 216TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-1125
Mailing Address - Country:US
Mailing Address - Phone:718-464-3139
Mailing Address - Fax:718-464-3139
Practice Address - Street 1:10222 216TH ST
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-1125
Practice Address - Country:US
Practice Address - Phone:718-464-3139
Practice Address - Fax:718-464-3139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency