Provider Demographics
NPI:1639446354
Name:DEPARTMENT OF EDUCATION
Entity type:Organization
Organization Name:DEPARTMENT OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUNELANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:COUTARD
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:646-436-6777
Mailing Address - Street 1:11032 64TH RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1418
Mailing Address - Country:US
Mailing Address - Phone:646-436-6777
Mailing Address - Fax:
Practice Address - Street 1:281 9TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5701
Practice Address - Country:US
Practice Address - Phone:212-563-4886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0147411320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities