Provider Demographics
NPI:1619230356
Name:KIDZ THERAPY SERVICES
Entity Type:Organization
Organization Name:KIDZ THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION ITINERANT TEACHER
Authorized Official - Prefix:MISS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MS
Authorized Official - Phone:516-747-9030
Mailing Address - Street 1:434 OCEANSIDE PKWY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2558
Mailing Address - Country:US
Mailing Address - Phone:516-286-9255
Mailing Address - Fax:
Practice Address - Street 1:300 GARDEN CITY PLZ
Practice Address - Street 2:SUITE 350
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3302
Practice Address - Country:US
Practice Address - Phone:516-747-9030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency