Provider Demographics
NPI:1851534424
Name:FIREFLIESNY
Entity Type:Organization
Organization Name:FIREFLIESNY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-355-9480
Mailing Address - Street 1:20 TERRACE PL
Mailing Address - Street 2:#1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1062
Mailing Address - Country:US
Mailing Address - Phone:718-355-9480
Mailing Address - Fax:888-599-1977
Practice Address - Street 1:20 TERRACE PL
Practice Address - Street 2:#1B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1062
Practice Address - Country:US
Practice Address - Phone:718-355-9480
Practice Address - Fax:888-599-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health