Provider Demographics
NPI:1013204841
Name:EARLY CHILDHOOD PROGRAM
Entity Type:Organization
Organization Name:EARLY CHILDHOOD PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR EARLY CHILDHOOD PROGRAM
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-680-1325
Mailing Address - Street 1:140 LESTER DR
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-1217
Mailing Address - Country:US
Mailing Address - Phone:845-680-1325
Mailing Address - Fax:845-680-1322
Practice Address - Street 1:140 LESTER DR
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-1217
Practice Address - Country:US
Practice Address - Phone:845-680-1325
Practice Address - Fax:845-680-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services