Provider Demographics
NPI:1245702638
Name:CHILDREN B WELL
Entity type:Organization
Organization Name:CHILDREN B WELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSNOVICH-BELKIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L MA
Authorized Official - Phone:917-209-5937
Mailing Address - Street 1:277 GREENCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-3246
Mailing Address - Country:US
Mailing Address - Phone:917-209-5937
Mailing Address - Fax:
Practice Address - Street 1:277 GREENCROFT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-3246
Practice Address - Country:US
Practice Address - Phone:917-209-5937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-22
Last Update Date:2018-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency