Provider Demographics
NPI:1932962438
Name:DEVELOPMENTAL ASSESSMENT & INTERVENTION CENTER, PLLC
Entity Type:Organization
Organization Name:DEVELOPMENTAL ASSESSMENT & INTERVENTION CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RISA
Authorized Official - Middle Name:
Authorized Official - Last Name:TABACOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-666-7687
Mailing Address - Street 1:83 ADAMS STREET
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507
Mailing Address - Country:US
Mailing Address - Phone:914-666-7687
Mailing Address - Fax:914-666-3666
Practice Address - Street 1:83 ADAMS STREET
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507
Practice Address - Country:US
Practice Address - Phone:914-666-7687
Practice Address - Fax:914-666-3666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty