Provider Demographics
NPI:1588197958
Name:CHILDREN MAKING STRIDES
Entity Type:Organization
Organization Name:CHILDREN MAKING STRIDES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:FISKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-563-5767
Mailing Address - Street 1:6 RESNIK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-5379
Mailing Address - Country:US
Mailing Address - Phone:508-563-5767
Mailing Address - Fax:
Practice Address - Street 1:6 RESNIK RD STE 210
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-5379
Practice Address - Country:US
Practice Address - Phone:508-563-5767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty