Provider Demographics
NPI:1851646772
Name:BISHOP LEON SULTON MULTICULTURAL CHRISTIAN ACADEMY
Entity Type:Organization
Organization Name:BISHOP LEON SULTON MULTICULTURAL CHRISTIAN ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOLMES-SULTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-733-7625
Mailing Address - Street 1:4457 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2406
Mailing Address - Country:US
Mailing Address - Phone:718-733-7625
Mailing Address - Fax:
Practice Address - Street 1:4457 PARK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2406
Practice Address - Country:US
Practice Address - Phone:718-733-7625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128324591174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty