Provider Demographics
NPI:1023468311
Name:ALFA KIDS
Entity type:Organization
Organization Name:ALFA KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAYERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-774-8080
Mailing Address - Street 1:8200 SHORE FRONT PKWY APT 8B
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-2143
Mailing Address - Country:US
Mailing Address - Phone:917-774-8080
Mailing Address - Fax:
Practice Address - Street 1:8200 SHORE FRONT PKWY APT 8B
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-2143
Practice Address - Country:US
Practice Address - Phone:917-774-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency