Provider Demographics
NPI:1831444207
Name:CHALLENGE EARLY INTERVENTION
Entity type:Organization
Organization Name:CHALLENGE EARLY INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ABA COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAIZY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARLSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:718-972-0880
Mailing Address - Street 1:1911 RICHMAOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310
Mailing Address - Country:US
Mailing Address - Phone:718-972-0880
Mailing Address - Fax:718-370-1597
Practice Address - Street 1:1911 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3913
Practice Address - Country:US
Practice Address - Phone:718-972-0880
Practice Address - Fax:718-370-1597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102704123252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency