Provider Demographics
NPI:1841733458
Name:EDUCATIONAL ESSENTIALS LITERACY SERVICE
Entity type:Organization
Organization Name:EDUCATIONAL ESSENTIALS LITERACY SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATOR SI /ABA ,TSHH
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED, TSHH
Authorized Official - Phone:347-862-4205
Mailing Address - Street 1:540 E 169TH ST
Mailing Address - Street 2:BRONX , NEW YORK SUITE 18A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-2632
Mailing Address - Country:US
Mailing Address - Phone:347-862-4205
Mailing Address - Fax:
Practice Address - Street 1:540 E 169TH ST
Practice Address - Street 2:BRONX , NEW YORK SUITE 18A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2632
Practice Address - Country:US
Practice Address - Phone:347-862-4205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency