Provider Demographics
NPI:1760884464
Name:ABC KIDS
Entity Type:Organization
Organization Name:ABC KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL INSTRUCTION TEACHER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-733-2746
Mailing Address - Street 1:73 BERKLEY ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1803
Mailing Address - Country:US
Mailing Address - Phone:347-733-2746
Mailing Address - Fax:
Practice Address - Street 1:3175 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5700
Practice Address - Country:US
Practice Address - Phone:347-733-2746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY838527390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty