Provider Demographics
NPI:1649025818
Name:VANGUARD NYC INC
Entity type:Organization
Organization Name:VANGUARD NYC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL ED TEACHER/ABA THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:DROZDOV
Authorized Official - Suffix:
Authorized Official - Credentials:MSSPED
Authorized Official - Phone:347-559-2812
Mailing Address - Street 1:3 CANYON RUN RD
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1101
Mailing Address - Country:US
Mailing Address - Phone:347-559-2812
Mailing Address - Fax:
Practice Address - Street 1:2108 81ST ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2572
Practice Address - Country:US
Practice Address - Phone:347-559-2812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency