Provider Demographics
NPI:1669776217
Name:MARIE PENSE CENTER LLC
Entity type:Organization
Organization Name:MARIE PENSE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANNOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:MSED,SBL,SDL
Authorized Official - Phone:212-362-7010
Mailing Address - Street 1:37 W 20TH ST STE 909
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3715
Mailing Address - Country:US
Mailing Address - Phone:212-362-7010
Mailing Address - Fax:
Practice Address - Street 1:37 W 20TH ST STE 909
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3715
Practice Address - Country:US
Practice Address - Phone:212-362-7010
Practice Address - Fax:212-362-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 252Y00000X
NY300000010000251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency