Provider Demographics
NPI:1780116616
Name:KIDSABILITATION INC.
Entity type:Organization
Organization Name:KIDSABILITATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:V
Authorized Official - Last Name:VICTORIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-395-3992
Mailing Address - Street 1:8047 268TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1543
Mailing Address - Country:US
Mailing Address - Phone:516-263-0418
Mailing Address - Fax:
Practice Address - Street 1:8047 268TH ST
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11004-1543
Practice Address - Country:US
Practice Address - Phone:516-263-0418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPT024147252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency