Provider Demographics
NPI:1689964298
Name:BOE
Entity Type:Organization
Organization Name:BOE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EDUCATION/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ST
Authorized Official - Last Name:KOMMATE-STEYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-882-4164
Mailing Address - Street 1:17206 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1836
Mailing Address - Country:US
Mailing Address - Phone:917-882-4164
Mailing Address - Fax:718-461-9578
Practice Address - Street 1:17206 35 AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358
Practice Address - Country:US
Practice Address - Phone:917-882-4164
Practice Address - Fax:718-461-9578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency