Provider Demographics
NPI:1295988749
Name:LONG ISLAND CENTER FOR CHILD DEVELOMENT
Entity type:Organization
Organization Name:LONG ISLAND CENTER FOR CHILD DEVELOMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-371-1818
Mailing Address - Street 1:385 PEARSALL AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1800
Mailing Address - Country:US
Mailing Address - Phone:516-371-1818
Mailing Address - Fax:
Practice Address - Street 1:385 PEARSALL AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1800
Practice Address - Country:US
Practice Address - Phone:516-371-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency