Provider Demographics
NPI:1619120060
Name:MARATHON INFANTS & TODDLERS, INC.
Entity Type:Organization
Organization Name:MARATHON INFANTS & TODDLERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ESRIG
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:718-423-0056
Mailing Address - Street 1:220-18 HORACE HARDING EXP.
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2227
Mailing Address - Country:US
Mailing Address - Phone:718-423-0056
Mailing Address - Fax:718-229-5370
Practice Address - Street 1:220-18 HORACE HARDING EXP.
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11364-2227
Practice Address - Country:US
Practice Address - Phone:718-423-0056
Practice Address - Fax:718-229-5370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY41800252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency