Provider Demographics
NPI:1740666924
Name:FRAIDY MILLER
Entity type:Organization
Organization Name:FRAIDY MILLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEACHER
Authorized Official - Prefix:
Authorized Official - First Name:FRAIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:718-438-0318
Mailing Address - Street 1:1440 54TH ST
Mailing Address - Street 2:APT#6H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4255
Mailing Address - Country:US
Mailing Address - Phone:718-438-0318
Mailing Address - Fax:
Practice Address - Street 1:1440 54TH ST
Practice Address - Street 2:APT#6H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4255
Practice Address - Country:US
Practice Address - Phone:718-438-0318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2320063252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency