Provider Demographics
NPI:1205310398
Name:BYDESIGN THERAPEUTIC GROUP, INC
Entity type:Organization
Organization Name:BYDESIGN THERAPEUTIC GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-922-2363
Mailing Address - Street 1:134 W 26TH ST RM 603
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6803
Mailing Address - Country:US
Mailing Address - Phone:212-604-9360
Mailing Address - Fax:
Practice Address - Street 1:134 W 26TH ST RM 603
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6803
Practice Address - Country:US
Practice Address - Phone:212-604-9360
Practice Address - Fax:212-604-9361
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY SOUNDS OF NY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency