Provider Demographics
NPI:1952806747
Name:LOOK WHAT I CAN DO LEARNING CENTER
Entity Type:Organization
Organization Name:LOOK WHAT I CAN DO LEARNING CENTER
Other - Org Name:LOOK WHAT I CAN DO LEARNING CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:201-470-0883
Mailing Address - Street 1:5600 KENNEDY BLVD W STE 110
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1256
Mailing Address - Country:US
Mailing Address - Phone:201-553-2200
Mailing Address - Fax:201-603-6610
Practice Address - Street 1:5600 KENNEDY BLVD W STE 110
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1256
Practice Address - Country:US
Practice Address - Phone:201-553-2200
Practice Address - Fax:201-603-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY540983174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid