Provider Demographics
NPI:1972866606
Name:MARATHON INFANTS & TODDLERS
Entity Type:Organization
Organization Name:MARATHON INFANTS & TODDLERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ESRIG
Authorized Official - Suffix:
Authorized Official - Credentials:EDD,
Authorized Official - Phone:718-423-0056
Mailing Address - Street 1:2061 PEARSON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4726
Mailing Address - Country:US
Mailing Address - Phone:718-951-6046
Mailing Address - Fax:
Practice Address - Street 1:2061 PEARSON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4726
Practice Address - Country:US
Practice Address - Phone:718-951-6046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276593891252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency