Provider Demographics
NPI:1679032015
Name:INESSAS NY CORP
Entity Type:Organization
Organization Name:INESSAS NY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:INESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOSOPOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-719-7186
Mailing Address - Street 1:7303 177TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1520
Mailing Address - Country:US
Mailing Address - Phone:646-719-7186
Mailing Address - Fax:
Practice Address - Street 1:7303 177TH ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1520
Practice Address - Country:US
Practice Address - Phone:646-719-7186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency