Provider Demographics
NPI:1639448343
Name:NYC DOE
Entity Type:Organization
Organization Name:NYC DOE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIFE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFONSO-GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-353-3150
Mailing Address - Street 1:95 MAYFAIR AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2446
Mailing Address - Country:US
Mailing Address - Phone:516-358-5320
Mailing Address - Fax:
Practice Address - Street 1:12802 7TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1218
Practice Address - Country:US
Practice Address - Phone:718-353-3150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022897251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)